


























LECTURES OF INTEREST 
TO WOMEN 


For Mothers 


and Nurses 


BY 

Royal A. McClure, m. d. 

w 

SPECIALIST IX OBSTETRICS AND 
THE CARE AND FEEDING OF 
INFANTS AND CHILDREN 


FIRST EDITION 


PRICK 85.00 



PUBLISHED BY 

SEATTLE MATERNITY HOSPITAL, INC. 


C. S. COLHOUER, MANAGING DIRECTOR 
BUSINESS OFFICE. 605 LYON BUILDING 

SEATTLE. WASHINGTON. 


U. s. A. 





COPYRIGHTED BY 

SIOATTLE MATERNITY HOSPITAL, inc. 

1010 


• • 


APR k6 ! 919 

©Cl A 5 1 5354 






PEKFECT HEALTH 







INTRODUCTION 


‘‘As upon the stainless skies 

Peaceful hangs the new born sun; 

So, upon thy bosom lies, 

Mother pure thy holy one, 

Ah, how lovely that repose, 

Mother, with the infant fair, 

Twined, as with the tender rose, 

Modesty, grace and sweetness are.’’ 

TO THE WIFE, MOTHER AND NURSE: 

We have selected for this book such lectures 
as will be most practical. We have explained in 
detail, as briefly as possible, the essential and 
practical knwoledge in regard to pregnancy and 
labor, including the after-care; the general care 
and feeding of the new-born infant during the first 
year; the general; care of older children, both in 
health and disease with a summary of each diseases 
as are common in childhood, together with their 
nursing and medical treatment. 

When possible, we have omitted medical terms 
and have written the lectures in simple language, so 
as to make them more clearly understood by the 
reader. Our aim has been to have the lectures act 
strictly as a teacher telling how. Therefore, they 
contain much detail. We have tried to express our¬ 
selves in a way that will be of practical benefit. 
Our chief object has been to give a clear knowledge 
of those subjects upon which every woman should be 
thoroughly informed. 

All late literature has been consulted, and 
we wish here to express our hearty thanks to the 
authors and publishers of the works so used, namely, 
DeLee, Garrigues, Grandue, Jarman, Marx, Kilmer, 
Tweedy, Griffith, Crulee, Holt, Williams, Clock, 
Fischer, Abt, and others. We are greatly indebted 
to Mrs. Royal A. McClure (a trained nurse), who has 
made valuable suggestions, and has assisted us in 
the preparation of our course of lectures on 
obstetrics for nurses. 


Page Five 



LECTURES OF INTEREST TO WOMEN 


The lectures contained in this book have a 
definite purpose. They will instruct the expectant 
mother upon matters of vital importance relating 
to her pregnancy, her confinement, and the care of 
her child. They will greatly assist the nurse in 
following out the physician’s orders. 

We want to impress upon you the necessity 
for better preparation and better care during 
pregnancy and childbirth. Many say that it is a 
natural occurrence and needs little or no attention, 
but we tell you it is the greatest science in medicine 
and when you treat the subject indifferently you 
make a great mistake. Statistics show that in the 
United States alone, over 20,000 women and children 
perish each year during confinement. This is 
largely due to the lack of proper knowledge of such 
cases both by the laity and the attendants. Why 
all this care and attention? Let us impress upon 
you the necessity of maternity homes and hospitals 
that make a specialty of confinement cases. When 
possible, every woman should be confined in an 
institution that specializes in obstetrics. Home 
is not the ideal place for confinement and it is a 
great satisfaction to know that the laity have 
learned to realize this fact. 

The third lecture in this course has been 
written to prepare and care for the patient at home. 
In many cases circumstances compel the patient to 
be confined at home, but it is not best for the 
patient. Your physician can do better work for you 
in a maternity home, where they have every facility 
for treating any complication that may arise. 

Poorly managed confinement cases mean poor 
health in after years, and we want to impress upon 
you the untold suffering which is the result of 
ignorance relative to pregnancy, confinement,, and 
the after care. 

There is a great deal being said and done 
about better babies. Various organizations are 
taking up this work and endeavoring to teach mothers 
about the care of their children. This is all well' 


Page Six 


INTRODUCTION 


and good in its place but if we are going to have 
mothers who are able to nurse and take care of 
their children we must have first a healthy and well 
mother, because breast feeding is a most important 
factor for the development of a healthy child. 

Now, how can an infant receive attention, proper 
nursing and care if the mother is in ill health. 

So let us first give the mother the proper care 
during her pregnancy, her confinement, and the 
lying-in period and we will lay the true foundation 
for better and healthier babies. 


Therefore, we have endeavored to place before 
you in simple language in these five lectures such 
knowledge as deals with the proper care that the 
young wife, the pregnant woman, and mother, should 
have. It tells the mother what she should know about 
the care and feeding of her child. It will assist 
the nurse in her work, and that the demand for this 
knowledge is greater today than in the past cannot 
be questioned. 

We trust nothing has been omitted which will 
give a clear understanding of the ‘‘Signs and 
Symptoms of Pregnancy,’’ ‘‘Hygiene of Pregnancy,’* 
‘‘Preparation of the Patient and Room for Con¬ 
finement, ’ ’ ‘‘Management of Labor, including the 
After Care,’’ and ‘‘The General Care and Feeding 
of the New Born Infant During the First Year.’’ 

We entreat you to study these lectures earn¬ 
estly and carefully and to regard them not as a 
reproach upon you, but rather upon the false system 
of educating wives and mothers that a confinement 
case is only a joke. There is a great necessity 
for enlightenment on this subject. Let the young 
expectant mother be thoroughly familiar with what 
is required to give her the best care, and when she 
obtains this knowledge she will eliminate much 
suffering for herself and secure better attendants 
(that is, physicians and nurses who have special¬ 
ized in this branch of the profession) to take her 
through the ordeal of childbirth. Years of 
experience as physicians and obstetricians tell 


Page Seven 




LECTURES OF INTEREST TO WOMEN 


us how much we need a change from ignorance to 
knowledge on this subject, and that is why we have 
prepared and selected these lectures for your 
study, as it is your right and duty, as a mother, 
to know and to become better educated along 
obstetrical lines. 

The Lectures in this book should be read thru 
several times regardless of paragraph, so that you 
will become familiar with them. The paragraphs are 
inserted for quick reference to any one part of the 
Lectures. 


Yours very respectfully, 

SEATTLE MATERNITY HOSPITAL, Inc. 


Page Eight 



PART I 


Contains four lectures 
relative to pregnancy and the 
lying-in period: ‘‘Signs 
and Symptoms of Pregnancy,’’ 

‘‘Hygiene of Pregnancy,’’ 
‘‘Preparation of the Patient and 
Room for Confinement,* * and 
‘‘Management of Labor, Includ¬ 
ing the After Care.’’ 









































































































































































































































































































































































































































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THE SIGNS AND SYMPTOMS OF 
PREGNANCY 


To-day let us take for our lesson the ‘‘Signs 
and Symptoms of Pregnancy.’’ 

By the term ‘‘Signs and Symptoms’* of Preg¬ 
nancy, we mean those conditions which a patient 
tells us, together with those which we find by 
examination. The conditions which the patient 
tells us we call ‘‘Symptoms’’ and those conditions 
which we discover personally we call ‘‘Signs.’’ 
Symptoms are subjective and signs are objective. 

We must not rely upon subjective symptoms to make 
a positive proof of pregnancy, but we must rely 
largely upon signs or the objective conditions that 
cause the changes of maternal organism which are 
brought about by conception, and the order of the 
appearance and variation of these changes that 
occur relative to the time of pregnancy gives the 
valuable information to determine if pregnancy 
is present. 

You as nurses may not be able to use in 
your practice all the signs given you, but you 
should be familiar with them because knowledge is 
power and it will make you a better assistant and 
a better nurse by having such knowledge. 

Now to ascertain with certainty that a woman 
is pregnant during the early stages requires very 
careful consideration from every detail regarding 
the case, and even then it is very difficult to say 
positively in some cases. As a rule many people in 
general believe it should be an easy matter to 
tell if a woman is pregnant, because they are not 
familiar with the various fallacies that underlie 
the symptoms of pregnancy. Sometimes the diagnosis 
of pregnancy can be made very quickly, but one must 
be warned in regard to ones statements, because 
the patient will discredit the physician if the 
event proves him wrong, and the same can be said of 


Page Eleven 



LECTURES OF INTEREST TO WOMEN 


the nurse. Therefore, much depends upon our deci¬ 
sion, so much that an accurate diagnosis is desired 
as it may involve the fair name of a virtuous woman. 
Therefore, it requires that the physician should not 
be reckless in his opinion, as mistakes may be dis¬ 
astrous to both mother and child. 

In the first few days of pregnancy there are 
no absolute signs of pregnancy. Later the positive 
signs develop; such as the fetal heart tones and 
movements. Oftentimes in making an examination 
it is impossible to obtain the proper findings, 
for instance, the woman may be too fat, a tumor 
may exist in addition to pregnancy, the abdominal 
cavity may be filled with fluid, the patient may hold 
the abdominal wall and perineum so rigid that none 
of the parts can be definitely outlined. This may 
be due to a patient being nervous or to tenderness 
in the abdomen, or it may be practiced with inten¬ 
tion to deceive. 

Thus a woman may be pregnant and she may wish to 
conceal it in order to get the attending physician, 
not knowingly, to produce abortion either with 
medicine given for amenorrhea, or by passing a 
sound into the uterus for diagnostic purposes. Or 
upon the other hand a woman may not be pregnant, 
yet she may want a positive opinion from the 
physician, that such is the case, in order to 
blackmail. Therefore, we cannot accept the state¬ 
ments of a patient as always being true. 

For the purpose of studying the Signs and 
Symptoms of Pregnancy, we will divide the period 
into three equal parts, namely, the first 3 months, 
the second 3 months, and the third 3 months. 

In the first 3 months we have the first 
important symptom of pregnancy and that is the 
cessation of menstruation, yet we must remember 
that there are three special fallibles which may 
underlie this symptom. 

Paragraph 2 

MENSTRUATION, as associated with the signs 
and symptoms of pregnancy:—As a general rule, when 
a woman who has always been regular, and her men- 


Page Twelve 



THE SIGNS AND SYMPTOMS 


struation stops, we say she is pregnant, although we 
have no right to make such a statement without due 
consideration, on account of the fallacies asso¬ 
ciated with menstruation relative to pregnancy. 


Paragraph 3 

CESSATION OF MENSTRUATION.—(a) Pregnancy 
may occur without menstruation, that is, a girl may 
become pregnant before puberty; (b) that a woman 
may become pregnant while nursing a child, which 
at this time under normal conditions, she does not 
menstruate; (c) menstruation may cease, caused by 
heart disease, tuberculosis, syphilis, anemia, 
change of climate and mental influences; also local 
disease, like atresia (closing of the hymen or the 
vagina). Menstruation will stop in cases where no 
cause at all can be given. These cases may become 
pregnant with no menstruation. Cases are recorded 
where pregnancy had taken place years after women 
have passed the change of life (the menopause). 

v Paragraph 4 

MENSTRUATION MAY CONTINUE DURING PREGNANCY. 

It is not rare to have cases where women will men¬ 
struate two or three times after conception has 
taken place. Generally the amount of blood is small 
and the character of the flow is usually abnormal. 
Cases are recorded where menstruation occurred 
during the entire period of pregnancy. It is well 
to remember when there is any abnormal hemorrhage 
relative to menstruation to suspect a case of preg¬ 
nancy has begun to develop. If such a case should 
come under your observation, advise your patient 
to consult her physician, as there should be a care¬ 
ful examination made to find out the cause of the 
irregular flowing or hemorrhage. 


Paragraph 5 

IRREGULAR MENSTRUATION.—Some women are 
habitually irregular, going several months at a 
time without menstruating, causing no ill health. 

Yet after taking all of these facts into con¬ 
sideration, we are reasonably safe to say, that a 
woman is pregnant whose menstruation has-been normal 


Page Thirteen 



LECTURES OF INTEREST TO WOMEN 


and stopped suddenly, providing, she is in perfect 
health; also her mental condition is normal, that she 
is free from worry, and her surroundings have been 
free from any changes, that is, she has not changed 
climate. 

You see the symptom relative to menstruation 
is valuable yet it is only presumptive. It is also 
useful in fixing the day of conception and deter¬ 
mining the day of labor. 

Paragraph 6 

MORNING SICKNESS. This is one of the early 
symptoms of pregnancy, usually occurring at the end 
of the fourth week. It may show itself earlier or 
later. Nausea varies indifferent individuals, 
some become quite sick and vomit profusely. There 
are cases where there is no morning sickness, nor is 
the stomach affected at all during the entire preg¬ 
nancy. About one-third of the pregnant women have 
nausea and vomiting as pregnant symptoms, and 
about one-third complain of it occasionally and 
gives very little trouble and about one-third are 
free from it entirely. 

Nausea and vomiting occur earlier, more con¬ 
stantly and more severely in the primipara than in 
the multipara, and women of the high-strung tem¬ 
perament have more than those of the hard working 
class. It is well to bear in mind that vomiting 
and nausea exist with the living child. It has been 
observed with authority that when the child dies 
in the uterus, the vomiting ceases. There are 
many other conditions that would produce vomiting 
similar to pregnancy, such as, acute or chronic 
appendicitis, tumors in the pelvis, pelvic peri¬ 
tonitis, and various other pathological conditions 
of the female organs. 

Paragraph 7 

SALIVATION. There is generally a slight 
increase in the saliva, accompanied with nausea. 

It may be determined as ‘‘cotton spitting,’’ occur¬ 
ring in women who have no pathological conditions or 
signs of salivation similar to that caused with 
mercurialization or drugs. This symptom has some 
value in determining the presence of pregnancy, 
though it may occur in other uterine conditions 


Page Fourteen 



THE SIGNS AND SYMPTOMS 


and hysteria. In some cases it is very marked and 
becomes quite profuse. There is also an inflamma¬ 
tion of the gums during pregnancy and more or less 
loosening of the teeth in some cases. The increase of 
saliva is probably caused by the toxemia conditions 
that are always present in the pregnant woman. 

Paragraph 8 

CHANGES IN DISPOSITION. The change in dis¬ 
position has been mentioned by some authors, yet 
the symptom is unreliable, because it can be auto- 
suggested by the patient. 

Paragraph 9 

IRRITABILITY OF THE BLADDER. The position 
of the pregnant uterus causes a change of position 
to take place with the bladder resulting in frequent 
urination. This we notice particularly in the 
first three months. This disappears after the 
uterus has enlarged sufficiently to bring it up into 
the abdominal cavity and occurs again in the last 
months of pregnancy when the uterus presses upon 
the bladder. 

Paragraph 10 

THE BREAST. As early as the fourth week 
there may be tingling and even shooting pains in 
the breast with some enlargement. The nipples 
become darker and more sensitive, also more erec¬ 
tile. The dark areola around the nipple becomes 
puffy as if there was air under the skin. The 
glands of the Montgomery become enlarged. Fluid 
may be expressed from the nipples as early as the 
twelfth week, but it may not be present until after 
delivery. Of these findings the most important 
is the change in the color of the areola, being 
much darker and there exists a puffiness which is 
very noticeable. These signs are more marked in a 
primipara than they are in a multipara. These 
conditions are of great importance when com¬ 
bined with other symptoms, and we must note that 
nervous women who are not pregnant may have tingling 
of the breast with an enlargement of Montgomery 
glands and fluid may be expressed from the nipple. 
Pelvic disease may produce the same condition. 
Therefore these conditions occurring other than 
in pregnancy lowers the value of this sign. 


Page Fifteen 





LECTURES OF INTEREST TO WOMEN 


Paragraph 11 

THE BLUISH DISCOLORATION OF THE VULVA AND 
VAGINA. This discoloration usually is most marked 
around the meatus and the vestibule, extending up 
into the interior wall of the vagina. It is of an 
opaque bluish tint with a tendency to violet. It 
appears about the end of the second month. It may 
not occur until the end of the third month, but be¬ 
comes more marked as pregnancy advances. It is more 
noticeable in multipara than in primipara and in 
women who have a catarrhal or any other diseased 
condition of the genitalia. It is quite marked 
in cases of contracted pelvis, especially in cases 
where the patient has had previous hard delivery. 
This sign is quite frequent, yet it may not appear 
until very late, and is not constant in all cases. 
This discoloration is essentially a local venous 
congestion and should disappear with any condition 
that would cause hemorrhage. Conditions aside 
from pregnancy may cause the same discoloration 
such as; menstruation or rapidly growing pelvic 
tumors, displacement of the uterus, in fact any¬ 
thing that interferes with the pelvic circula¬ 
tion, which would have a tendency to obliterate. 
Therefore, this is not a sign of positive value and 
can only be used in connection with other signs 
and symptoms. . 

Paragraph 12 

SOFTENING OF THE CERVIX AND VAGINA. The con¬ 
gestion of the pelvis due to pregnancy is manifested 
very early by softening of the vagina and the 
cervix. In primipara this is noticed about the 
sixth week, or even earlier in the multipara, by 
an acute observer. The lower part of the cervix 
softens first. There is also a noted softening of 
the walls of the vagina, with an increase of the 
leucorrheal discharge. Some leading obstetricians 
put much value on this sign and say: ‘‘If the 
cervix feels as hard as the cartilage of the nose, 
no pregnancy exists; if it feels like the mucous 
membrane of the lip, pregnancy is possible.’’ 

We must remember that a chronic inflammation of 
the cervix will cause it to remain hard and rigid 
even though pregnancy is present and will soften 


Page Sixteen 


THE SIGNS AND SYMPTOMS 


but very little until the last months of pregnancy. 
Therefore, this sign also can only be presumptive 
and associated with the other signs and symptoms. 

Paragraph 13 

HEGAR’S SIGN. This is known as the softening 
and compressibility of the isthmus uteri and lower 
uterine segment. You as nurses may not be able to 
make the necessary examinations to note some of the 
different signs, but we want you to become familiar 
with them so you can intelligently assist your 
physician. On examination the isthmus uteri is 
compressed between the two fingers in the fornix 
and the abdominal wall. In typical cases the 
fingers can be so close together that the uterine 
tissue between seems to be reduced to a very thin 
membrane. Of course, in fat women it is more diffi¬ 
cult to make this examination. Also this is true 
when the abdominal muscles are held rigid. In 
these cases one finger in the rectum and the thumb 
in the vagina often gives good results. In order to 
get this sign in some cases it is necessary to give 
the patient an anaesthetic and draw the uterus 
down with Yulsselum forceps. This sign appears in 
multipara at the sixth week, but it is seldom 
fully developed until the tenth week. This dis¬ 
appears when the uterus attains a size and height 
which make the parts inaccessible. 

This is a well marked sign of pregnancy and 
is highly presumptive and one of the most reliable 
in the first three months of pregnancy, and it can 
only be diagnosed by the physician, yet we must 
remember that other conditions cause this soft¬ 
ening. We often find it after an abortion or labor, 
in congested condition of the uterus, occasionally 
before menstruation, chronic pelvic inflammation, 
and displacement of the uterus. Also tumors in 
the uterine wall, such as fibroids, will produce this 
condition or rigidity of the parts, therefore, 
it cannot be ascertained with certainty. 

Paragraph 14 

CHANGES IN FORM, SIZE, CONSISTENCY AND 
POSITION OF THE UTERUS. Within two weeks after 
conception, the shape of the uterus begins to 


Page Seventeen 



LECTURES OF INTEREST TO WOMEN 


change. The first noticeable change is an increase 
in the anteroposterior diameter of the body of the 
uterus. The ovum softens and causes the uterus to 
enlarge where the ovum is located, which is generally 
on the side near the entrance of one of the tubes, 
thus causing one side of the uterus which contains 
the ovum to become thick and soft, while the other 
side is small, thin and hard, there being a groove 
between. These findings are useful in the 
diagnosis of pregnancy. After the second month 
one finds the uterus enlarged laterally. 

In the third month the body of the uterus 
assumes nearly a spherical form. The consistency 
of the whole uterus is spongy, elastic and soft like 
bread dough, and one notices the organ harden under 
the examining finger, that is, it contracts. 

An enlargement of the uterus gives rise to one of 
the most suspicious signs of pregnancy. A steady 
increase in size is one of the most valuable signs we 
have. Three examinations at regular intervals 
are required and they must be made very carefully 
and the findings recorded. 

Paragraph 15 

FORM. The physician first notices the 
change in the form of the uterus at the first 
examination, and then makes comparison in three or 
four weeks when the second examination is made. 

Paragraph 16 

SIZE. At the time of the examination if the 
tumor corresponds in size to the period.of preg¬ 
nancy, such a diagnosis is always certain, as the 
normal enlargement of the pregnant uterus does not 
correspond in growth to any other kind of uterine 
tumors, so remember the steady increase of the 
uterus is one of the most valuable signs we have. 

If two or three careful examinations are made at 
regular intervals, say three or four weeks apart, 
and there is an increase in the size of the uterus 
that corresponds in size to that expected for 
pregnancy, we can say with certainty, the woman 
is pregnant. If the uterus should enlarge as it 
would under normal pregnancy and then become small 
again, you would suspect an undeveloped ovum. 


Page Eighteen 



THE SIGNS AND SYMPTOMS 


Paragraph 17 

CONSISTENCY. As mentioned the uterus when 
pregnant becomes spongy, elastic and soft, resem¬ 
bling dough, and is one of the signs that can be 
used very early in the diagnosis of pregnancy. 


Paragraph 18 

POSITION OP THE UTERUS. The strong ante¬ 
flexion of the uterus, that is~, bended forward upon 
itself, and lying like a lump of dough upon the 
bladder, serves to draw the attention to a possible 
diagnosis of pregnancy. This is immediately 
noticed upon the introduction of the finger into 
the vagina. 

These four signs taken together, and by an 
experienced examiner, are sufficient to make pos¬ 
sible a positive diagnosis of pregnancy. 

Paragraph 19 

GENERAL CONSIDERATIONS. In making the 
examination to verify the above conditions, the 
bowels and bladder should be emptied, all tight 
clothing removed, with the patient lying appro¬ 
priately draped and at ease on a bed or table, and 
if you will in this way prepare a patient for a 
physician to examine, he will follow a definite 
order that all points may be considered. One must 
not be satisfied with one or two of the Signs and 
Symptoms, but they must all be taken collectively. 
The examination should be made under antiseptic 
precaution. The examiner should be guarded in 
making a positive diagnosis during the first three 
months only under the most favorable circumstances. 
Better leave the answer in doubt and request the 
patient to return for a second examination at a 
time when the positive signs of the second three 
months are present. 


Paragraph 20 

DIAGNOSIS OF PREGNANCY by examination of 
the blood by ‘ 4 Aberhalden’ ’ promised to be of great 
value. It depends on the determination of the 
ferment in the blood of the. pregnant woman. 
Experience teaches in laboratory work, that theo- 


Page Nineteen 



LECTURES OF INTEREST TO WOMEN 


retically it is perfect; but practically the 
reaction cannot be controlled so it is not a positive 
sign. 

Paragraph 21 

WE ALSO HAVE a chemical examination of the 
urine, which is claimed by some to be of value in the 
diagnosis of pregnancy. Take certain urine, when 
the patient is free from any kidney trouble, and have 
it examined similar to the Wassermann reaction. It 
is known as ‘ 6 The Complement Fixation for the Diag¬ 
nosis of Pregnancy with Urine. ’ ’ What is said of 
the examination of the blood can also be said of the 
urine, it is not a positive sign. 

In conclusion, to sum up the diagnosis of 
pregnancy, let us see what are the most positive 
factors: 

Paragraph 22 

IN THE FIRST THREE MONTHS: 

1. Morning sickness. 

2. Cessation of menstruation. 

3. Size, form, position and consistency of 
the uterus. 


IN THE SECOND THREE MONTHS: 

1. Foetal heart beats (not constantly 
present). 

2. Size of uterus. 

3. Foetal movements (quickening). 

4. Size of uterus corresponding to the time 
of pregnancy. 

IN THE - THIRD THREE MONTHS: 

1. The detection of foetal parts and 
movements. 

2. Size of uterus corresponding to the time 
of pregnancy. 

Now if the most positive symptoms and signs 
are present in connection with all the other signs, 
and we can exclude all fallacies of each, we can 
say with certainty, that the woman is pregnant. 


Page Twenty 



HYGIENE OF PREGNANCY 


Paragraph 23 

At this hour, ladies, we will talk about the 
hygiene of pregnancy, that is, how a pregnant 
woman should take care of herself, and we will 
teach you how to give her the proper instructions. 
Let us say that pregnancy is a natural physiological 
process, yet it may at any time become pathological, 
with serious results. There are several reasons 
why a pregnant woman should have special care, 
namely: all the nervous system is under a great 
strain; the heart, liver and kidneys have extra work 
to do, then there is a metabolic change that takes 
place between the developing foetus and the mother, 
not well understood, yet these changes produce 
poison leading to very serious results. The special 
point for you t-o keep, in mind is that pregnancy 
modifies and tests all the systems of the body, 
and this is why we should pay special attention to 
the patient’s health during the time of her 
pregnancy. 

Women are usually extremely ignorant of all 
things concerned with pregnancy and their confine¬ 
ment and think they need no medical attention 
during pregnancy, and how inefficient it is, from a 
medical standpoint, to have a physician take a 
patient’s name, date of her confinement, and then 
not see her again until he is summoned to her labor. 

Women are gradually learning these facts 
and consult the doctor as soon as they believe them¬ 
selves to be pregnant and engage him for their 
confinement earlier now than formerly; earlier 
among the wealthier classes, earlier in the city 
than in the country, earlier in the United States 
than in most other lands. Many advantages arise 
from this, in that it may enable the doctor to 
learn the traits and constitution of his patient, 
watch for any abnormal condition, and prepare her 
properly for the labor. This practice should there- 


Page Twenty-one 



LECTURES OF INTEREST TO WOMEN 


fore be encouraged. You will be asked many ques¬ 
tions by pregnant women, and you must be able to 
give them such instructions and other common 
information as will be of value to them. So today 
we will instruct you in regard to the ‘‘Hygiene of 
Pregnancy.’’ 


Paragraph 24 

DRESS. Now, let us first consider the dress. 
The clothing that is worn by a pregnant woman should 
be simple and warm, even in the summer, woolen 
underclothing of the lightest weight is to be 
recommended and heavier should be worn in the 
winter. This would especially be true if there is 
any inflammation of the kidneys. All clothing 
should be hung from the shoulders by suspenders or 
a corset waist. Heavy skirts should not be worn and 
supported from the waist. In place of wearing 
heavy skirts, it is better to wear warm closed 
underwear, and this keeps the body warm and pre¬ 
vents infection from street dust. 

Paragraph 25 

SHOES. Low heels and broad toes are best, 
as the pregnant woman throws her head and shoulders 
back, in order to keep her balance. This makes an 
angle in the small of the back, and gives the 
patient a peculiar gait, and when the heels are 
elevated, it throws the body still more forward. 
Then the woman is compelled to throw the head and 
shoulders further back. This will cause pain in the 
loins and stretching of the abdominal muscles. 

Paragraph 26 

CORSETS. There should be no circular con¬ 
striction of clothing at any part of the body. 
Corsets, tight waistbands, or elastic garters, 
should not be worn. In multipara and in most primi- 
para, towards the end of the pregnancy, a light 
waist and an abdominal support, of proper form, 
that will lift up the lower abdomen, will give 
great comfort. There are some very good maternity 
waists and supports on the market, the best being 
the ‘‘Patterson Supporter,’’ the ‘‘Kabo or Ferris 
Maternity Corset,’’ and the ‘‘Stork Corset.’’ We 


Page Twenty-two 



HYGIENE OF PREGNANCY 


especially recommend the last two. The ordinary 
corset is particularly ' injurious during pregnancy 
as it forces the child down into the pelvis and 
against the lower abdominal wall, causing con¬ 
gestion of the pelvis veins and weakness of the 
abdominal muscles. Too tight lacing of corsets 
restrains the expansion of the uterus, causing 
deformities of the child, such as club foot, etc. 
Women who wish to conceal pregnancy by tight lacing 
may do themselves and the child an irreparable 
injury. 

Paragraph 27 

DIET. There is no strict rule governing the 
diet of pregnancy, yet the diet should be simple. 

The amount of meat should be limited. Not more than 
four ounces a day should be consumed of meat, meat 
broths and eggs. Pastry, highly seasoned salads, 
starches fried in fats, and too much fried foods 
in general should be avoided. A pregnant woman’s 
diet should consist largely of cereals, vegetables, 
and fruits, especially fruits, as they will have 
a tendency to keep the bowels regular. She should 
drink plenty of water, at least five full glasses 
daily, and should drink a glass full of water before 
retiring and one upon rising in the morning. 

Milk taken with meals is an ideal food for patients 
who care for it. Buttermilk should be especially 
recommended. Alcoholic liquors and stimulants 
of any kind should be avoided for two reasons, 
because they have a tendency to produce the liquor 
habit, and at the same time they are injurious to 
the child. Pregnant women should not eat too much, 
but as a rule they may eat anything they can digest, 
but only at meal times. Do not let your patient 
destroy the natural appetite by eating between 
meals. 

Fat women may restrict liquids, but never so 
much that the daily amount of urine is reduced 
below 30 to 40 ounces. It is much better to decrease 
the general diet if it is necessary. 

Coffee and tea, not too strong and in moderate 
amounts, can be taken with safety when they do not 
interfere with digestion and there is no consti¬ 
pation. 


Page Twenty-three 



LECTURES OF INTEREST TO WOMEN 


Paragraph 28 

BOWELS. Constipation is especially the rule 
among women and more so during pregnancy. It must 
not be neglected, as it may lead to the most serious 
consequences. It is true that a case of chronic 
constipation cannot be cured during pregnancy, 
but it is necessary in most of these cases to give 
more or less drugs, in connection with other 
treatment, in order to keep the bowels regular. 

The following treatment will be found very satis¬ 
factory and is one you can recommend and use in 
your work. 


TREATMENT OF CONSTIPATION DURING PREGNANCY. 

Paragraph 29 

THE PATIENT should have a regular time for 
the bowels to move each day. 

The best time is shortly after breakfast. 
Should no movement occur, it is best to use a glycer¬ 
ine suppository or an enema at this time. A desire 
for the movement of the bowels at any time must not 
be resisted. Abdominal massage is not permissi¬ 
ble during pregnancy. 

Paragraph 30 

EVERY MORNING, just after rising, and every 
evening, just before retiring, the patient should 
drink a glass of cool water and eat some fruit, an 
apple or an orange, and drink plenty of water be¬ 
tween meals. 

Paragraph 31 

THE DIET should contain fruit and vege¬ 
tables in abundance, especially spinach,.peas, 
beans, barley, tomatoes, corn, and foods of this 
kind, but we cannot use as much of such foods as in 
cases where a woman is not pregnant. Tea is for¬ 
bidden, but coffee in moderate amount is allowed. 
Prunes, figs and dates are to be eaten, providing 
they do not cause indigestion, and, if well 
masticated, this can be avoided to a great extent. 

Paragraph 32 

IN SOME CASES it is of value to have the 
patient every night before retiring, inject into 


Page Twenty-tour 





HYGIENE OF PREGNANCY 


the rectum, 4 to 6 ounces of ordinary olive oil, 
leaving it there all night. This is a valuable 
remedy in cases of spastic constipation. What 
we mean by spastic constipation is a condition 
where there is a spasmodic contraction of the 
muscles of the rectum. 

Paragraph 33 

DRUGS ARE WITHHELD as far as possible, and 
active cathartics entirely. Cascara Peptonoids, or 
the bitter extract (2 to 8 grains) given in capsules, 
gives the best results. ‘‘Phillip’s Milk of 
Magnesia,’’ given from 2 to 4 teaspoonfuls, is also 
good. Both the Cascara and Milk of Magnesia are 
given at bed time. Begin with the smallest dose 
and increase gradually until the desired effects 
are obtained. One may alternate for a week every 
month or so with a saline apperient, and of the 
many on the market the best is ‘‘Pluto Water.’’ 
Medicines are discontinued as soon as the patient 
is taught to do without them. Palatable petroleum 
or liquid petroleum as it is better known, may also 
be given to good advantage. A dessert spoonful 
placed in one-half a wine glass of cold water 
taken two or three times a day, will assist greatly 
in keeping the bowels regular. It is often taken 
once a day in combination with other drugs. 

Paragraph 34 

CULTOL, which is also a petroleum preparation, 
can likewise be taken with good effects. Care must 
be used in taking Cultol to have the spoon hot, by 
dipping it in hot water, and take only a level spoon¬ 
ful, placed well back on the tongue, best taken half 
hour before meals. 

When the line of treatment just given, does 
not give relief, the case needs special medical 
attention, and the attending physician should be 
consulted. 


Paragraph 35 

KIDNEYS. The action of the kidneys during 
pregnancy is very important. When there occurs 
in the urine certain abnormal elements, we know that 


Page Twenty-five 






LECTURES OF INTEREST TO WOMEN 


dangerous conditions are developing, which occurs 
as eclampsia or toxemia. (These conditions will 
be taken up in detail at some future lecture.) Now, 
let us impress upon you how necessary it is to make 
frequent examinations of the urine during preg¬ 
nancy. The urine should be examined every four 
weeks until the seventh month. During the seventh 
and eighth months, the urine should be examined 
every two weeks and every week during the last 
month, and if at any time, there is any suspicion 
of eclampsia or toxemia, it should be examined 
every day. The patient should be instructed to 
send 4 ounces of the morning urine at regular 
intervals to be examined as directed by her physi¬ 
cian or nurse. Once a month, the amount of urine 
passed in 24 hours should be collected in a suitable 
container and measured. It must not be less than 
50 ounces. A good plan each time the urine is to 
be examined is to examine the 24 hour specimen, 
as it is necessary to measure it, the pregnant 
woman sends 4 ounces of the 24 ounce specimen foi 
examination. Tests are made for albumen, sugar, 
specific gravity, urea and the reaction. For prac¬ 
tical purposes, finer examinations are not neces¬ 
sary. The presence of albumen tells us that we 
have serious complications to deal with, which 
will be explained to you later in the course, as 
well as in your lectures on urinalysis when this 
will be taken up in detail. We have made these 
urinalysis for years and have been rewarded by 
discovering and forestalling many cases of probable 
eclampsia or toxemia. 


Paragraph 36 

BLOOD PRESSURE. The blood pressure in 
obstetrical cases is very important, as much so 
as the examination of the urine, because toxemia 
of the kidneys can be determined by this method 
fully six weeks before the presence of albumen is 
found in the urine. 


Paragraph 37 

HIGH PRESSURE in pregnancy tells us that 
toxemia is present and we may expect eclampsia, 
as there is absolutely no rise, caused by the 


Page Twenty-six 



HYGIENE OF PREGNANCY 


pregnant condition itself, and any increase should 
be regarded as highly suspicious and thoroughly 
investigated. 

Paragraph 38 

IT IS CONSIDERED highly dangerous to carry 
a patient through the 280th day with a pressure 
over 145 because eclampsia is almost sure to occur. 
In normal cases of pregnancy, it will run low and 
even throughout the 280 days. 

Paragraph 39 

YOU MAY ALSO REMEMBER that labor pains cause 
a rapid rise in blood pressure. It falls between 
pains, rises again with the next pain, and so on 
until delivery. After the confinement, it will 
remain a trifle above normal for three or four 
days; after that it resumes its normal condition. 

Paragraph 40 

THE INSTRUMENT USED to take blood pressure 
is called the ‘‘Sphygmomanometer. ’* The ‘‘Tycos’’ 
type is the best. You will be instructed how to 
take blood pressure in your clinical work, and the 
instrument will be explained to you. The use of 
this instrument in obsteterics cannot be too 
strongly emphasized, as we can at all times tell 
exactly our patient’s condition, and the condition 
of the kidneys, and we can always tell exactly 
whether our patient is improving or not. There¬ 
fore, it is perfectly obvious that by its use 
the dangers of eclampsia are minimized. 

Paragraph 41 

EXERCISE. Violent exercise during preg¬ 
nancy is to be avoided. We cannot build up a strong 
muscular system during pregnancy. This should 
have been accomplished before. Pregnant women 
should be instructed to use great caution not 
to receive sudden jolts. They should be warned 
against running, sudden motion, lifting great 
weights, going up and down stairs quickly, horse¬ 
back riding, motoring over rough roads, golf, 
tennis, dancing, and swimming. They should take 
exercise by walks up to two miles daily in the 
sunlight, and the general housework is desirable, 


Page Twenty-seven 




LECTURES OF INTEREST TO WOMEN 


unless too strenuous. Travel, such as railway 
and ocean voyages, is not to be recommended. 
Patients differ. Some women can stand a great 
deal of exercise and do most remarkable things and 
suffer nothing, while in others this would bring 
on miscarriages and they would suffer from the 
slightest provocation. It is always well to be on 
the safe side and limit the amount of strenuous 
exercise. 

Paragraph 42 

A GENERAL MASSAGE is to be recommended and 
is often useful, but the breast, abdomen and 
varicose veins must be avoided. None of these parts 
should be irritated in any way by manipulation 
or massage. Theatre going is to be recommended, 
but this should be in moderation, as crowds are 
to be avoided as much as possible. 

Paragraph 43 

COITUS DURING PREGNANCY'. This is a subject 
of great importance, on which much has been written, 
and which has been fully discussed by different 
authors. The weight of opinion is that it should 
be forbidden during gestation, especially the 
first three months and the last three months, 
because the three first months it has a tendency 
to produce abortion and the last three months 
infection. Coitus during pregnancy also, in a 
great many cases, causes a nervous shock to women 
whose nerves are already overtaxed. It increases 
the leucorrhea and often increases the nausea and 
vomiting. Some pregnant women look upon inter¬ 
course at this time with disgust, while in others 
the desire is increased, but upon the whole it 
is detrimental and should not be practiced. 

Paragraph 44 

BATHING. Very cold and very hot baths, hot 
sitz baths and ocean bathing are to be avoided, as 
they have a tendency to cause uterine contraction. 
Warm daily baths, as well as cool sponge baths are 
to be taken freely, as they aid the kidneys in the 
work of excretion and preserve the person from 
odor and act as a general stimulant and keep the 
skin in good condition. Bathing of any kind, 


Page Twenty-eight 




HYGIENE OF PREGNANCY 


which causes the patient to feel exhausted after¬ 
ward, should be avoided. A general massage after 
bathing is very grateful to the patient, but the 
breast, abdomen and varicose veins must be avoided, 
as they should receive no irritation in the way 
of manipulation. For the profuse sweating, 
which is sometimes annoying, and for a general 
stimulant to the skin, a brisk rub with a ‘ ‘salt 
towel’’ is useful. A salt towel is made by wringing 
a bath-towel out of a strong brine made with common 
table salt and drying it. It must be remembered 
that a full tub bath during or near labor is 
not to be recommemded on account of infection 
gaining entrance into the vagina, therefore, it 
is better during the last 6 or 8 weeks of pregnancy 
to employ the shower bath. In this connection we 
will mention vaginal douches, and, unless they 
are indicated by some disease and prescribed by a 
physician, they should not be used as a general 
routine, and if used occasionally, only mild 
antiseptics should be employed. The water should 
not be too hot and should be given under low pres¬ 
sure that is, don’t have the fountain syringe 
elevated above the patient over 2 feet. Five 
grains of potassium permanganate to the quart of 
water is a good antiseptic to use. You can have 
the druggist put up 5 grain powders of potassium 
permanganate for such use. If the hands become 
stained with permanganate, peroxide of hydrogen 
will remove it. Such a douche is only used to keep 
the parts clean. 


Paragraph 45 

MENTAL OCCUPATIONS. Most women have enough 
to do to look after their house hold duties and 
their general health without taking up any mental 
or intellectual studies with the view that the child 
will be made intellectual, and it is best to dis¬ 
courage the reading of such medical books that 
describe the anatomy and physiology of the female 
pelvic organs. This should be accomplished 
before pregnancy. Possibly the study of music and 
the various arts, but not to excess, will do her 
no harm, but rather keep the mind away from self. 


Page Twenty-nine 



LECTURES OF INTEREST TO WOMEN 


Now, this brings us to a subject that we hear a great 
deal of talk about and one that may interest you 
greatly. 


Paragraph 46 

MATERNAL IMPRESSIONS. By this term is meant 
those impressions on the mind or body of the child 
in the uterus which result from a similar impres¬ 
sion on the mind or body of the mother. The belief 
that if a pregnant woman should see an ugly or 
terrifying object, it would be reproduced in the 
offspring, dates from remotest antiquity, and is 
spread all over the world, even in darkest Africa. 
This idea exists among the civilized and uncivil¬ 
ized and even some medical men are quoted in its 
support. Nevertheless, most of the late writers 
call it absurd and harmful. Blondel, of London, 
fought against the theory. We cannot always 
prove our medical belief by physical laws and we 
must admit the influence of heredity which we 
cannot as yet explain. The argument against the 
theory of maternal impressions are: 

Paragraph 47 

FIRST. There is no nervous connection 
between the mother and the foetus. 

SECOND. The child is completely formed at 
the end of the sixth week, a time that pregnancy is 
usually not recognized, and we find in studying 
literature along this line that most of the cases 
reported the mental shock as occurring much later 
during pregnancy. 

THIRD. All the monstrosities observed in 
the human are found in the lower animals, and in a 
much greater number. Many, many times immediately 
after the child is born the mother will anxiously 
ask you if the baby is 4 ‘marked’ ’ but her fears are 
seldom realized. She had seen something during 
pregnancy that she felt sure would mark the child, 
but this did not occur. The weight of authority 
is in favor, according to our best scientific 
knowledge, of the belief that the effect of the 
mother’s mind on the physical well-being of the 
child is absolutely unfounded. 


Page Thirty 



HYGIENE OF PREGNANCY 


Paragraph 48 

IT MUST BE REMEMBERED, however, that a 
violent emotion causes extreme nervousness to 
nursing mothers, and can so affect the milk that • 
the child gets sick from it, and even has convul¬ 
sions in some cases. This is a fact attested by 
honest observers. Great mental excitement can 
produce abortion, and let us mention at this 
time the fact that worry will stop menstruation 
extending over a period of from one to four 
or five months. These facts show that an impression 
upon the mother’s mind is transmitted to the uterus, 
but they do not explain how the destructive action 
on the foetus is produced. We know that physical, 
mental and temperamental traits in either parent 
are transmitted to the offspring. How the germ 
becomes affected so that it can carry these delicate 
but permanent impressions, is a question. 

Perhaps modern science will explain it, but we 
are not thoroughly familiar with it at the present 
time. 

Paragraph 49 

JUST REMEMBER that in many cases of supposed 
maternal impression, where there i-s a plausible 
connection between the nervous shock and the 
deformity of the child, there is not the slightest 
ground for believing that such a teratogenic 
(monster) connection would exist. Therefore, 
it is difficult to discover any relation between 
the mind of the mother and the child that could not 
be explained by the laws of heredity, as we under¬ 
stand them at the present time. We do not wish 
to go on record as saying positively that there is 
no such influence between the mother and the 
child, but personally we do not believe in it and 
when the question is asked “Could anything I have 
done or seen affect my baby?’ ’ , the nurse and the 
physician can conscientiously answer, “In the 
present state of our scientific knowledge, there is 
no basis for such fears.’’ 

Paragraph 50 

CARE OF THE NIPPLE AND BREAST. The breast 
requires more or less care during the entire life 


Page Thirty-one 



LECTURES OF INTEREST TO WOMEN 


of the individual. The number of women able but 
unwilling to nurse is small and growing smaller 
each year. The number of women unable to nurse 
•their babies is enormous, and the evil effects are 
noticeable in our infant mortality tables. It is a 
great misfortune if a woman cannot nurse her infant 
if only for a short time. The care of the breast 
should begin early in life and the prevention of 
inflammation of the breast while nursing a child 
will be more fully discussed under the ‘‘Care of 
the Mother after Confinement.’’ In growing girls, 
the breasts and nipples need care, and when they 
develop at puberty, provision for this growth by 
proper dress should be made. Pressure or injury 
must be avoided, so you see it is important that 
the breast should receive a certain amount of 
attention from birth. 

Paragraph 51 

SOME WOMEN, during pregnancy, require some 
form of bust supporter to hold up the large heavy 
breasts. During her bath a pregnant woman should 
exercise care not to hurt the glands. The fine, 
branny scales which accumulate on the nipple, 
if allowed to remain, form crusts, which leads to 
the formation of cracks in the skin. This will 
cause infection of the nipple during nursing. 

The nipples should be washed once or twice a week 
when taking a bath, with liquid green soap and 
water. They should then be dried and sterile cocoa 
butter should be applied. This removes the fine 
scales which accumulate on the nipples and keeps 
the skin soft and pliable. 

Paragraph 52 

WITH BLONDES and red-haired women, and others 
with tender nipples, after they have been washed 
with green soap as directed, a lotion which is 
highly astringent like the Tannate of Glycerine, 
as prescribed by the attending physician, should be 
used once or twice a week during the last six or 
eight weeks of pregnancy. 

After this astringent lotion has dried in, 
the nipples are to be anointed with the sterile 
cocoa butter. No strong astringent washes, like 


Page Thirty-two 




HYGIENE OF PREGNANCY 


pure alcohol, need be used, as they harden the 
nipples, which will cause them to crack under the 
efforts of the child nursing. Remember, the object 
is to keep the skin of the nipples soft and pliable, 
and if the nipples are given the care as outlined, 
you will have very little, if any, trouble. 


Paragraph 53 

INVERTED NIPPLES from birth can seldom be 
improved from treatment. If in any case where there 
is much deformity of the nipples, or if the nipples 
are undeveloped and pressed in by improper dress, 
an attempt may be made, during the last six weeks of 
of pregnancy, to draw them out with the fingers 
by giving daily treatment. 


Paragraph 54 

PRESERVATION OF THE FIGURE. It is only 
natural and proper that women are anxious that 
pregnancy and child bearing should not leave the 
person in an ungainly shape. The most common 
complaint is that the patient develops a high 
stomach after labor, yet it is a fact that the 
necessary changes that take place during pregnancy 
have a tendency to beautify the figure, although 
some women do not look at it in this light, yet it 
causes a rounding of the hips and abiroadness of the 
bust and a more matured appearance, all of which 
have a tendency to give a woman a more beautiful 
figure. 


Paragraph 55 

FOR THE PREVENTION of high stomachs or ex¬ 
treme prominence of the lower abdomen, much may be 
done. Stretching of the abdominal walls and uterus 
has a tendency to cause a weakened and relaxed con¬ 
dition of the abdominal muscles. To prevent this, 
the ordinary corset, as we have mentioned, should 
not be worn during pregnancy. It adds to the strain 
on the lower abdomen, and thus favors muscular 
weakness. High-heeled shoes are another factor 
that causes strain on the abdominal muscles, over¬ 
straining during labor, and allowing gas to form in 
the bowels after labor, are also causes. 


Page Thirty-three 



LECTURES OF INTEREST TO WOMEN 


Paragraph 56 

TO PREVENT muscular insufficiency, one 
must begin with the little girl. She should 
develop herself as the boy does, with sports, such 
as swimming, climbing, dancing, etc. 

Paragraph 57 

WHEN A YOUNG WOMAN, she should not lace and 
paralyze the abdominal muscles. Healthy exercise 
with the whole body should form a part of a girl’s 
and young woman’s daily routine. 

Paragraph 58 

THE ABDOMEN may need some support during the 
last three months of pregnancy, and this may be 
obtained by one of the maternity corsets recom¬ 
mended. This support is especially needed in mul¬ 
tipara with already weakened walls, with twins, 
and when the patient has an extremely large stomach. 

Paragraph 59 

AFTER THE BIRTH of the child it is your duty 
as a nurse to see that the bowels are regularly 
emptied and that gas does not accumulate in the 
intestines. The binder does not prevent high 
stomach, yet it will help and the best benefit is 
obtained from it when the patient first leaves the 
bed. To assist in bringing the abdominal wall back 
to its original size the nurse should, after the 
uterus has sunk into the pelvis, give the abdominal 
muscles a daily five-minute massage. This will 
help to tone up the muscles, cause them to contract, 
which will reduce the size of the abdomen, but mas¬ 
saging at this time will not prevent the formation 
of the lines noticed on the skin due to pregnancy 
caused by such stretching. The skin may be massaged 
gently with olive oil during pregnancy. It may help 
some to prevent such lines. Several remedies are 
advertised to prevent this, but you will find them 
of little or no value. 

Paragraph 60 

MINOR DISTURBANCES OF PREGNANCY. It might be 
well, in connection with the hygiene of pregnancy, 
to add a few of the common disturbances that occur 
during pregnancy. You, as nurses, as well as we. 


Page Thirty-four 


HYGIENE OF PREGNANCY 


physicians, are consulted about certain conditions 
that develop during pregnancy, and it is wise to in¬ 
struct the pregnant woman to report such conditions 
to her physiciarf, since he may detect in them the 
beginning of serious illness. Other conditions 
aside from these .have been, or will be, mentioned 
throughout the course, but these minor conditions 
are so closely associated with the hygiene of preg¬ 
nancy that we will consider them at this time. 

Paragraph 61 

MORNING SICKNESS: Morning sickness is very 
common in pregnant women between the first and the 
fourth months. The sickness occurs generally as 
soon as the patient gets out of bed in the morning, 
but it may occur at any time during the day and some¬ 
times only in the evening. It can often be relieved 
by giving her a meal of tea and toast before rising. 
Special attention should be given to the patient’s 
bowels and she should drink water freely. If a 
light meal before rising does not quiet the trouble, 
she should be instructed to take a light diet and 
eat nothing in the morning until she gets up, and 
has her regular spell of vomiting. After this she 
can generally retain food. 

Paragraph 62 

SHOULD IT BE REQUIRED to quiet the stomach, 
such drugs as Ingluvian, Subgalate of Bismuth, 
Sodium Bicarbonate in proper preparations, as pre¬ 
scribed by the physician, are of value. Such a 
powder should be given upon waking in the morning 
and another just before taking the morning meal in 
bed. Then the powders may be taken anytime during 
the day when the sickness occurs, as often as every 
2 or 3 hours, if necessary. Another good combina¬ 
tion is Bicarbonate of Soda, aromatic spirits of 
ammonia, and' the infusion of gentian. This can be 
given three times a day, half hour before meals in 
amounts as ordered by the physician. 

Paragraph 63 

NOW, there has been a great many treatments 
and prescriptions given for morning sickness of 
pregnancy, but they will all fail in aggravated 


Page Thirty-five 


LECTURES OF INTEREST TO WOMEN 


cases, and when the sickness becomes troublesome a 
physician should be consulted, as it may be a case 
that requires especial attention, as one of the 
serious complications of this condition occurring 
in pregnancy is uncontrollable vomiting. 

Paragraph 64 

INSOMNIA is rare, and is usually due to 
digestive disturbances and nervous conditions. 

The same may be said of constant dreaming. If regu¬ 
lation of the diet and bowels does not suffice, 
simple remedies often will. For example, one or two 
glasses of hot malted milk just before bedtime, a 
hot water bag placed at the feet, sleeping alone 
with <a super-abundance of fresh air, warm baths, or 
an electric vibrator at the back of the neck. Some 
cases may require medical attention and the physi¬ 
cian generally prescribes a dose of sodium bromide 
—10 to 15 grains, or veronal-—5 to 10 grains, at 
bedtime for a few times, but never gives morphine. 
Wakefulness is a frequent symptom of early preg¬ 
nancy and requires no treatment. Late in gesta¬ 
tion, it is always to be regarded with suspicion, 
as it may indicate the beginning of eclampsia. 
Mental dullness may mean the same. 

Paragraph 65 

NUMBNESS AND TINGLING of the hands and feet, 
usually combined with slight puffiness, not real 
odema, are the evidences of mild neuritis, perhaps 
toxic in origin. Occasionally local tenderness of 
the corresponding nerves is discovered. While the 
symptom rarely has any disturbing sequels, it 
should be watched. Treatment is on the theory that 
it is due to toxemia. Neuralgia also occurs in some 
cases. Pregnant women often complain of cramps in 
the muscles of the arms and legs, yet real tetany 
seldom appears. 


Paragraph 66 

TOOTHACHE: When there are any decayed teeth 
present in the beginning of pregnancy, you will 
advise your patient to go to the dentist at once and 
have them thoroughly attended to, as later in preg¬ 
nancy she is likely to have more or less neuralgia, 


Page Thirty-six 



HYGIENE OF PREGNANCY 


and the decayed teeth are bad for the stomach. When 
decayed teeth develop late in pregnancy, unless the 
pain is very severe, palliative methods are to be 
used. 

Paragraph 67 

SORE GUMS: If the gums annoy the patient and 
become sore, and there is an increase of saliva, a 
tooth brush should be used freely with some astrin¬ 
gent mouth wash, as alum—10 grains to the ounce of 
water—or a 50% solution of peroxide of hydrogen. 
There is a powder called Pyorrhocide, put up in a 
tin container, and retails for a dollar. This is 
very good in such cases. 


Paragraph 68 

PAINS IN THE ABDOMEN are frequently com¬ 
plained of by pregnant women. If the pains occur 
during the early months of pregnancy, a careful 
examination should be made by a physician in order 
to exclude tubal pregnancy. Pain is the symptom of 
many conditions, such as appendicitis, inflamma¬ 
tion of the uterus, stones in the kidneys, adhe¬ 
sions, and so on. Intercostal neuralgia is rare, 
the pain in the lower ribs from which so many women 
3 uffer is mostly due to dragging on the thoracic 
cage by the recti muscles, which carry the weight 
of the large uterus. For this, the abdominal sup¬ 
porter is indicated. Rheumatic pains also occur 
and relief may be obtained from the use of a lini¬ 
ment, or you can use Huxley’s cream or Rheume Olum, 
both of which are very good ointments to relieve 
the pain. 

Paragraph 69 

STRETCHING OF THE SKIN sometimes causes pain. 
Relief may be obtained from lubricants, such as solid 
albolene, cocoa butte"-, or rose water ointment. 

Paragraph 70 

FAINTING SPELLS: Dizziness, and attacks of 
weakness demand a thorough examination by the at¬ 
tending physician, to see if there is any heart or 
lung trouble. Sometimes it is caused by a highly 
nitrogenous diet and relief is obtained through 
dietary measures. Iron and phosphorus tonic is often 


Page Thirty-seven 


LECTURES OF INTEREST TO WOMEN 


useful. A preparation known as 4 ‘Phosphagon’’, made 
by the Arlington Chemical Company, is an excellent 
tonic for such cases, the dose 1 to 4 teaspoonfuls 
three times a day after meals. Fresh air is essen¬ 
tial. Palpitation of the heart, is relieved by a cold 
drink, but if fainting is frequently repeated medical 
care is imperative. When dyspnea (that is, difficult 
breathing) occurs it is often due to indigestion, 
wrong dressing and the dragging down of the pregnant 
uterus. 

Paragraph 71 

FREQUENT URINATION is usually due, in the 
early months of pregnancy, to a slight catarrh at the 
base of the bladder. When women complain of urinary 
troubles, a careful examination and urinalysis are 
to be made at once. It is natural for women to urinate 
very frequently during the first three months and the 
last three months of pregnancy. 

Paragraph 72 

HEART BURN: A great many patients complain of 
heart burn, with more or less gas and indigestion. 

You must look to the general hygiene of the patient, 
the regulation of the diet, and some gastric tonic 
will often give relief. A capsule that contains 5 
grains of Abbott’s intestinal antiseptic and 
5 grains of peptensyme may be given after meals, as 
it is effective in controlling the gas and indiges¬ 
tion. In connec.tion with the above, patients can 
take one or two tablets of carmenzyme any time during 
the day that there is a distressed condition of the 
stomach with formation of gas. The carmenzyme 
tablets should be chewed up before swallowing and 
they should be taken half hour after eating with a 
few sips of water in order to obtain best results. 

Paragraph 73 

SKIN ERUPTIONS: Acne, mostly facial, may 
prove rebellious under treatment during pregnancy. 
It generally disappears after labor. Wash the parts 
with tincture of green soap and water, then apply 
alcohol and open the pustules with a fine lancet and 
apply hot applications of saturated solution of 
Epsom Salts, which will give as good results as any¬ 
thing you can do. 


Page Thirty-eight 





HYGIENE OF PREGNANCY 


Paragraph 74 

ITCHING OF THE SKIN: Such conditions as pro¬ 
fuse leucorrhea, or vaginal discharge, will cause 
an intense itching in the vulvular regions. For this 
trouble, a lead lotion will give some relief. 

Put % ounce of the liquor plumbi subacetatis 
fort, to the pint of water and instruct your patient 
to wash the parts night and morning with a weak solu¬ 
tion of green soap and water, and afterwards bathe 
the parts freely with the lead lotion. 

Resinol ointment may be used in place of the 
lotion, if the irritation is almost unbearable, as 
it is in some cases. 

Any ointment that contains menthol, or tar, is 
good, as the ointment protects the parts from moist¬ 
ure and stops the itching. It will be more satis¬ 
factory in such cases to consult the physician and 
let him prescribe. 

Paragraph 75 

DOUCHES should not be given unless advised by 
the physician, and that would be only in cases where 
the itching could not be controlled by the above 
treatment. If a douche is resorted to, it is best 
to give it in the bath tub and the fountain syringe 
should be placed only two or three feet above the 
patient’s hips, using no douche point, but simply 
the plain rubber tube. A good solution to use would 
be one dram of borax to every quart o*f water used. 

A good douche powder for such cases is Abbott’s 
Vaginal Antiseptic Powder. Use one or two teaspoon¬ 
fuls to the quart of water. 

Paragraph 76 

A SITZ BATH is also recommended. The use of 
ichthyol or tar soap has a soothing effect. When 
the discharge and the itching has ceased, stop all 
treatment. 

Paragraph 77 

FOR THE ECZEMA that may exist on the genitalia 
and under the woman’s breast, it should be washed 
frequently with tar soap and water followed by very 
careful drying and then use a dusting powder of 
zinc stearate. 


Page Thirty-nine 


LECTURES OF INTEREST TO WOMEN 


Paragraph 78 

SWELLING OF HANDS AND FEET: The swelling of 
the hands and feet should always command atten¬ 
tion, because while in many instances it is due to 
stasis, the swelling disappears when the woman lies 
down, yet most cases are due to a toxaemia or a 
kidney condition, and need medical aid and should 
be reported to the physician. Especially is this 
true when swelling of the hands and feet are asso¬ 
ciated with swelling of the eyelids. 


Paragraph 79 

VARICOSE VEINS of the legs often occur, espe¬ 
cially in multipara, and generally cause more or 
less pain. The treatment is rest, properly ap¬ 
plied bandage, and keep the legs elevated. The 
best bandage to use is the cloth woven elastic 
bandage, known as the Crepe Bandage. It should be 
applied from below, starting at the ankle. Put it 
on in the morning, or after the patient has remained 
in bed, with the legs elevated, and the swelling is 
reduced. This bandage should be removed at night. 


Paragraph 80 

SILK ELASTIC BANDAGE is also of great value, 
and is very effective in a great many cases. It 
can be secured from the druggist or from the firms 
that make a specialty in artificial limbs and 
trusses, which should also be removed at night. 

In some cases the veins are so distended that 
they will rupture, and in order to stop a severe 
hemorrhage, if such should occur, place a pad made 
out of a handkerchief directly over the vein, and 
apply the bandage sufficiently tight, thus control¬ 
ling the hemorrage until medical aid can be secured. 


Paragraph 81 

LENGTH OF PREGNANCY. We cannot be positive, 
nor give any fixed rule that will tell exactly the 
date of confinement. This is true even if we know 
the exact date that conception took place, because 
labor often occurs as the result of some trauma, 
fright or any other disturbance. If we reckon our 


Page Forty 



HYGIENE OF PREGNANCY 


date from cessation of menstruation, it is abso¬ 
lutely unreliable because women do menstruate during 
the first months of pregnancy, and conception may 
occur during a^period of amenorrhea, that is, in 
cases where we have no menstruation. 

If we figure from the time conception takes 
place, when this data can be obtained, and reckon 
from that date, the average pregnancy will be 
270 days. 

Paragraph 82 

FROM TIME IMMEMORIAL, women have reckoned 
two hundred and eighty days, ten lunar months, or 
nine calendar months, counting from the first day 
of the last period as the length of normal gesta¬ 
tion, and for practical purposes this may be ac¬ 
cepted, because in the majority of cases it holds 
good, but one must remember that some children 
require more time in the uterus for full develop¬ 
ment than others, depending upon the maternal con¬ 
ditions, because you know some seed in favorable 
soil grows faster than others, and so it is with 
the infant. 

Paragraph 83 

A GOOD RULE and one as reliable as any to 
reckon the date of confinement is to take the date 
when the last menstruation began, count back three 
months and add seven days. Thus, if a woman’s last 
menstruation began January 1st, that is, before 
pregnancy took place, count back to October 1st and 
add seven days, which will make her date of confine¬ 
ment October 7th.. Labor may occur a few days before 
or after this date, but it can be relied upon as 
being as nearly correct as any other, and the one we 
wish you to remember and use in your practice. You 
will find in first pregnancy it will be more correct 
than in multipara. In the later cases it will gen¬ 
erally be a few days later. 

Paragraph 84 

THE LENGTH OF PREGNANCY is often reckoned 
from the time of quickening. By the term quickening 
we mean the first time the mother feels the move¬ 
ments of the child in the uterus. It usually occurs 
from the 15th to the 20th week, generally the 18th 


Page Forty-one 




LECTURES OF INTEREST TO WOMEN 


week. Now from the date of quickening add five cal¬ 
endar months. For example, if quickening occurred 
on June 4th, labor may be expected about November 4. 

Paragraph 85 

In fixing the date of confinement, it is well 
to note the height of the uterus. At the end of the 
ninth month it is up to, or almost up to, the ensi- 
form cartilage, and at the end of the tenth lunar 
month (owing to the downward descent of the uterus) 
it is again half-way between the ensiform cartilage 
and umbilicus. 

Paragraph 86 

The following table for calculating the date 
of confinement, as compiled by Dr. Ely, is fairly 
correct and convenient, and is used by a great many. 


HU 


5 * 
2l $ 


IH11 






ssssskssssssssssssssssss 

ssssssssssssssssssssssss 

SSSSSSSSSSSSSSSSSBSSSSSS 

5S3S383Sa358:3;i3S3S33;5Sa;J 








CD 

CD > * 

r^H -H CO 
■P tlO-H 


Page Forty-two 






























HYGIENE OF PREGNANCY 


Paragraph 88 

‘‘MISSED LABOR’ ’ is a term used where pains 
begin on the date when expected, but cease, and 
normal labor does not occur for several days later. 
In rare cases, the child dies and is carried in the 
uterus a greater or shorter time. A dead ovum 
carried in the uterus is not pregnancy. When the 
pregnant woman ceases to feel any motion of the 
child she should notify her physician. 

Paragraph 89 

THE AGE of the woman and the sex of the child 
influence the length of gestation. Statistics show 
that young women are likely to have a shorter gesta¬ 
tion than older ones. Again, women who have been 
sterile for years and old primiparas are likely to 
go over term. Women who began to menstruate late, 
say at 16 or 17 years of age and have painful men¬ 
struation and long, hard rigid cervixes, are likely 
to have delayed labor. Young primiparas often 
fall into labor a few days before the date set, the 
tense abdominal wall forcing the head into the 
pelvis against the cervix, which causes the pains to 
begin. In the same individuals the second child 
would undoubtedly be carried longer. As to the sex 
of the child, males are said to be carried in the 
uterus longer than females. Women who are active in 
the last months of pregnancy are less likely to go 
over term than the idle woman who takes no exercise. 
In summer, women are likely to give birth earlier 
than in winter, and then again heredity seems to 
play a role; thus if a mother has children at the 
seventh month, her daughter would have children at 
the same time, or if the mother’s labors were pro¬ 
longed the same conditions would exist in her 
children. 

Paragraph 90 

NOTE: The earliest authentic pregnancy is 
reported by Bodd. He gives the girl as being 8 years 
and ten months old and she gave birth to a child 
weighing about seven pounds. Pregnancy in girls of 
12 to 15 years is not rare, and experience shows that 
most of the children live and that labor is not very 
difficult. In these cases, the child is usually 


Page Forty-three 



LECTURES OF INTEREST TO WOMEN 


small, with a soft head, which accounts for the un¬ 
expected safety of the labors. The latest pregnancy 
on record that we know of is reported by Kennedy. 
The woman was 62 years old and this was her twenty- 
second labor. Cases are reported where women have 
been delivered at the age of 52 years, and in these 
cases you must remember that menstruation had been 
absent for years. 



Page Forty-four 





PREPARA TION OF THE PA TIENT 
AND ROOM 


Paragraph 91 

IF ANY ONE of these talks is more important 
than the other, it seems that this one should be 
considered the most important of all—the prepara¬ 
tion for the aseptic conduct of labor. Thousands of 
mothers and children die every year because of the 
lack of such preparations. The principles of asep¬ 
sis and antisepsis are not complicated nor diffi¬ 
cult to apply, and there are two great principles 
that we want you to always remember. 

First: Everything that comes in contact with 
the puerperal wounds must be absolutely sterile. 

Second: The external genitalia and introitus 
vagina must be rendered thoroughly aseptic. 

Paragraph 92 

THE IDEAL and complete system of asepsis, as 
you will learn in your hospital practice in this in¬ 
situation, is not possible in the private home, 
but. unless your patient goes to a maternity hos¬ 
pital for the delivery the same preparations must 
be made at home for a confinement case as for a major 
surgical operation, and you must learn how to make 
these preparations. Do not be content, nor consider 
that ideal asepsis has been carefully carried out, 
by simply having a basin of bichloride solution and 
a roll of absorbent cotton. No doubt some of these 
terms just used sound like Greek to you, but we are 
going to take time to explain and analyze them in 
detail so that you will thoroughly understand what 
we have just said to you. 

Paragraph 93 

ASEPSIS means absence of septic matter. When 
we say your hands are aseptic, we mean they are free 
from infection and incapable of contaminating 
others with the causes of putrefaction. 


Page Forty-five 



LECTURES OF INTEREST TO WOMEN 


ANTISEPSIS means preventing or counteracting 
putrefaction. 

Paragraph 94 

STERILE means absence of bacteria, that is to 
say, we destroy bacteria by sterilization. This is 
accomplished by heat or by the use of various solu¬ 
tions that render the parts sterile. We use heat at 
a high temperature, as will be explained to you when 
you are taught to operate the sterilizer. You will 
not have the advantage of the sterilizer in homes, 
therefore we must resort to other methods of boiling 
or baking our dressings in the oven of a common cook 
stove. When we boil instruments, towels, sponges, 
and various other articles, they are rendered 
sterile. When we apply proper solutions to the skin 
we render it sterile, and we treat the hands in a way 
that renders them sterile. We can also sterilize 
any part of the body upon which we wish to operate. 
When anything is sterile we render it aseptic, and 
it is free from all septic matter. When we say that 
a nurse is sterile, we mean that she has prepared her 
hands properly and clothed herself with a sterile 
gown. She is aseptic because she is free from all 
septic matter and cannot infect her patient, and 
she does her work in an antiseptic way, because she 
is preventing infection. 

Paragraph 95 

NOW, ASEPSIS, antisepsis and sterilization 
are three great words. Write these words, as we have 
given them to you, on your cuffs, if you will, in 
your notebook, write them with their definitions in 
big letters on a card, hang them in your room some¬ 
where where you can see them several times a day and 
thoroughly master them. Read all the literature 
you can find on these three great subjects. 

Paragraph 96 

NOW, what does all this infection mean? It 
means that if your hands, or anything that comes in 
contact with your patient, are not sterile you will 
infect her; that is, you would be the carrier of 
germs that would cause the infection, and if you 
infect your patient she will have puerperal fever, 


Page Forty-six 


PREPARATION OF THE PATIENT 


or childbed fever, as it is commonly known. This 
will be fully taken up in detail in your lecture on 
puerperal fever, but let us say this, that whenever 
infection occurs, one, or all, of three persons are 
at fault: the doctor, the nurse or the patient. So 
let us learn in the beginning how important it is 
that we, as physicians and nurses, do not infect any 
of our patients. If we should in our practice have 
a case of infection, be sure that the fault has been 
with the patient and not from the nurse or the physi¬ 
cian. Therefore, let us learn at this time how to 
sterilize the hands, dressings and the patient, so 
as to prevent infection. 

Paragraph 97 

TO STERILIZE the hands you should wash them 
with soap and water at least ten or fifteen minutes 
(liquid green soap is best), using a hand brush and 
scrubbing the ends of the fingers thoroughly, as 
well as the hands and arms. Carefully remove all 
the dirt under the nails with an orange wood stick. 
It is a good idea to keep the nails fairly short. 

Wash your hands thoroughly in this way as well as 
the arms up to the elbows, using running water- from 
the hydrant. If you use a washbowl, or basin, as 
you find in some homes, change the water often. 

After thoroughly scrubbing the hands and arms as 
directed you will next immerse them into a bichlor¬ 
ide solution, 1-3000, or wash them thoroughly 
with the same—then treat them the same with the 
lysol solution, about 1-400. Have someone pour 
alcohol over your hands, or have the alcohol in a 
basin, then take a sterile sponge and saturate with 
alcohol and sponge the hands and arms. 

Paragraph 98 

Remember the routine: 

First—Wash the hands with liquid green soap 
and water for ten or fifteen minutes; 

Second—Immerse or wash in bichloride solu¬ 
tion 1-3000; 

Third—Use the Lysol solution 1-400 the same 
as the bichloride; 

Fourth, and last—Use the alcohol. 


Page Forty-seven 




LECTURES OF INTEREST TO WOMEN 


At no time in the preparation of the hands is 
it necessary to dry them with a towel unless after 
using the alcohol you wish to put on dry sterile 
gloves, then be sure the towel is sterile; it is best 
to let the alcohol dry on the hands, rather than use 
a towel. Now, with this preparation we say that 
your hands are sterile, or in other words, they are 
clean. They cannot carry any infection, and if you 
do not handle unsterilized dressings, or articles, 
you cannot infect your patient. 

Paragraph 99 

IT MIGHT BE WELL to mention here that when you 
first arrive at your case you should wash the hands 
and use the bichloride as directed. That is the 
first thing to do, and it will render your hands 
sufficiently sterile to prepare your patient. It 
may be necessary to wash the hands occasionally and 
use the bichloride during the preparation, espe¬ 
cially this should be done when you are ready to wash 
the parts and render the genitalia aseptic, but any 
time during confinement that you wish to render the 
hands sterile follow out the instructions we have 
given you, using soap and water, bichloride, lysol 
and alcohol. In some maternity homes and hospitals 
as well as in private practice, the bichloride solu¬ 
tion and alcohol are omitted, but we advise the use 
of these in the homes as well as in maternity homes 
and hospitals. If you will follow the simple rules 
as we will teach you for securing asepsis of your 
hands, the lying-in woman and her surroundings in 
general, you will approximate the same aseptic con¬ 
ditions which are secured today in our best mater¬ 
nity hospitals. 

Paragraph 100 

AS AN EXTRA PRECAUTION, after sterilizing the 
hands we wear surgical rubber gloves, sterilized 
either by the dry or wet method; that is, they are 
sterilized dry in the sterilizer or they are boiled 
in a vessel and the gloves are put into a lysol solu¬ 
tion, and by putting some of this solution into the 
gloves they can easily be put on. 

If your hands have been in bichloride and you 
wish to put on gloves, have an assistant pour a very 


Page Forty-eight 


PREPARATION OF THE PATIENT 


little sterile green soap on your hands and you will 
experience no difficulty in putting them on. Re¬ 
member about the green soap when you are having any 
difficulty in putting on gloves. 

Paragraph 101 

TO STERILIZE GLOVES by boiling, wrap them up 
in a piece of gauze, or small napkin or towel, and 
place them in a vessel, either by themselves or with 
the instruments and dressings. It is well to ster¬ 
ilize one extra pair of gloves separately for the 
examinations prior to delivery, and the delivery 
gloves are sterilized with the instruments. When 
sterilizing gloves in a separate vessel, it is well 
to place a small plate over them to hold them down 
in the water, and then, after they have boiled thor¬ 
oughly, they can be poured into the lysol solution. 
When sterilizing gloves in the home, always boil 
them. 

Paragraph 102 

WHEN GLOVES are dry sterilized it is done 
with the regular sterilizer and they are put on dry 
after powdering the hands and inside of the gloves 
with sterile talcum powder. When putting on dry 
gloves, after immersing the hands in the lysol, 
bichloride and alcohol solutions, the hands must be 
perfectly dry before you put the gloves on. You 
see, we have wet and dry sterilization for gloves as 
well as for dressings. You will receive more de¬ 
tailed instructions on sterilization in your hos¬ 
pital practice from the superintendent in charge. 
Now, we want especially to call your attention at 
this time to the proper way to prepare the delivery 
room and patient in a home so that when you are sent 
out to prepare a patient for delivery, you will have 
everything in readiness when the physician arrives 
to take care of the case. 


Paragraph 103 

YOU WILL NOTICE quite a difference between 
the conveniences you have in the delivery room of 
our institution, or any hospital, compared with 
what you will find in a private home. In the former 
case you have everything needed right at hand and 


Page Forty-nine 




LECTURES OF INTEREST TO WOMEN 


in the latter, unless unusual foresight has been 
used, you have practically nothing. 

In homes you do not find the facilities to 
work with that we have in the hospital. In place of 
having the sterilizer to sterilize your dressings, 
towels, gloves, aprons, gowns, sheets, and so on, 
it will be necessary for you to use the kitchen stove 
as a makeshift. 

Paragraph 104 

WHEN YOU HAVE TIME, take the dressings, 
towels, pads, cotton, etc., and place them in an 
old pillow case, or wrap them in an old sheet, 
sprinkle over it enough water to make it quite damp, 
and put in an ordinary bread pan and bake in the 
oven. Watch it occasionally. Dampen each package 
as required and leave it there until it is thorough¬ 
ly baked, so to speak, that is, until the outer 
cover is brown, as we must use heat to kill germs and 
to sterilize our dressings and render them aseptic, 
and that is the way it is accomplished in the home. 

Paragraph 105 

THE INSTRUMENTS will be given you by the phys¬ 
ician in charge and you will proceed to sterilize 
them, in the following manner. 

When time is an important factor and you have no 
dressing prepared before the call, take an ordinary 
good-sized hand towel, which is spread out to cover 
the bottom of the pan, needles, silk worm—gut, 
soft rubber catheter, 2 eye droppers, tape for 
tying the cord, and such instruments as are needed 
for a normal case; namely, 2 pair of scissors 
(straight and curved), one-half dozen artery for¬ 
ceps, needles, needle holder, and any other instru¬ 
ments ordered to be sterilized by the attending 
physician. 

After you have placed these articles in the 
pan, cover them with the folded ends of the towel. 
Now take ordinary surgical cotton in pieces large 
enough to make a medium-sized sponge and place a 
great many of them on top of the towel that covers 
the instruments and articles needed for a normal 
case. Add to the above a fountain syringe wrapped 


Page Fifty 


PREPARATION OF THE PATIENT 


in a towe.l, which might be needed in case of hemor¬ 
rhage. Now, put in as many towels as you need, a 
couple of Turkish towels and a few hand towels; 
cover them over with water and boil for about 20 
minutes. It is well to put a large plate over them 
to hold the towels down and use the plate for the 
medicine droppers, ligatures (silkworn gut) needles 
and tape for tying the cord, so that they will not 
get mixed with the instruments that you will need to 
use in case of any laceration where repair work has 
to be done. You arrange these after they are cooled 
and ready for use. 


Paragraph 106 

To cool the instruments and dressings that 
have been boiled in the dishpan, pour most of the 
water off and set them in the bathtub and let enough 
cold water run in the tub so that the pan will just 
float. Do not let any water get into the pan. 

Paragraph 107 

You will need a basin for bichloride solution 
and one for lysol solution. Take two granite basins 
or some cooking utensil that will hold about two 
quarts, fill each about two-thirds full of water 
and place On the gas stove and boil thoroughly. Cool 
in the same manner by setting in the bathtub. Put 
four small, or one large, bichloride tablets in one 
vessel and three teaspoonfuls of lysol in the other. 
This will make the solutions of bichloride and lysol 
of sufficient strength, providing you have a quart 
and a half of water in each vessel. You had better 
measure it to be sure by using either a pint or quart 
cup, such as you will find in the kitchen. If you 
always measure the amount of water and know the exact 
quantity of drugs used, then you will make no mis¬ 
take . 

Now, in regard to these solutions of bichlor¬ 
ide of mercury and lysol, let us consider them more 
fully and separately so as to give you a.thorough 
understanding of each. 

Paragraph 108 

(a) THE BICHLORIDE. In hospital practice, 
to make the bichloride solution, you will use stock 


Page Fifty-one 




LECTURES OF INTEREST TO WOMEN 


solutions, but in private practice, you will use 
tablets, dissolving them in hot water and adding 
cold sterile water to make up the required solu¬ 
tion, which should be about 1-3000, the strength 
generally used in obstetrical practice. Yet the 
strength may vary from 1-1000 to 1-10,000, as may be 
ordered by the physician. You must use care to 
avoid poisoning with bichloride, see that the tab¬ 
lets are thoroughly dissolved. Some physicians 
have discarded it entirely, others use it very 
little; personally we have never seen any bad 
effects and feel safer when it is used. The tablets 
are made in two sizes, 7 3/10 grains and 1 41/50 
grains. Three small tablets or one large tablet to 
the quart of water makes a 1 - 3000 solution. 

Always use the colored tablets. They make the solu¬ 
tion blue. 

Paragraph 109 

(b) LYS0L SOLUTION. This solution is in 
general use, I believe, among all obstetricians. 

It is a preparatory antiseptic containing fifty per 
cent of Creosol and Tincture of Green Soap, Liquor 
Creosolis Compositus is the official name. Some 
hospitals use stock solutions, but the use of the 
pure drug is very convenient, and in private prac¬ 
tice you will make up the solution by adding three 
drams (three teaspoonfuls) of Lysol to a quart of 
sterile water. This makes a one per cent solution, 
which is the required strength. Remember, always 
measure both the water and lysol. Do not trust to 
guesswork. 

Paragraph 110 

There is a new antiseptic and germicide on 
the market known as Ziratol that bids fair to take 
an important stand in obstetrical practice. It is 
supposed to take the place of both Bichloride and 
Lysol. The manufacturers make great claims for it. 
To make the solution of required strength, add four 
(4) teaspoonfuls to a quart of sterile water. Per¬ 
sonally, we have not used it. 

Paragraph 111 

Now, in addition to the bichloride and lysol 
solutions, you will need both cold and hot sterile 


Page Fifty-two 



PREPARATION OF THE PATIENT 


water. A good way to secure sterile water is to 
take four ordinary quart fruit jars with covers and 
boil them thoroughly in a large pan or washboiler. 
After they have boiled twenty minutes, fill them up 
with boiling water and put the covers on just tight 
enough to cover the jars. Set them aside to cool. 
If in a hurry, cool them quickly by setting them in 
the bathtub. Be careful and not have too much water 
in the tub. This will give all the cold sterile 
water that will be needed. You can put a kettle of 
water on the stove to boil for the hot sterile 
water. Always keep plenty of hot and cold sterile 
water on hand. 


Paragraph 112 

If you are required to hurry, and do not have 
time for so much detail, you can hasten matters by 
disinfecting the vessels that you want to make your 
solutions in by putting about one tablespoonful of 
alcohol into the pan or basin you wish to sterilize, 
rinsing it around so that you are sure the alcohol 
gets all around on the sides of the vessel, as well 
as the bottom. Then light the alcohol with a match, 
being careful that the flame sets nothing afire, 
including your own clothing. This will sterilize 
a vessel very quickly and effectively. The vessel 
should be thoroughly washed first and a little 
bichloride solution put into it and rinsed out with 
sterile water; then sterilize it with alcohol, as 
directed. Put in one and a half quarts of boiling 
water, and when cool, it is ready to use to make any 
solutions that you wish; or to save time, if you have 
it on hand, use the required amount of cold sterile 
water to cool the hot. 


Paragraph 113 

You will also need a small dish. Take one 
that you will find in the cupboard; sterilize it 
thoroughly, as directed with alcohol, then fill it 
about two-thirds full c.old of bichloride solution 
and place your catgut ligatures in same: two tubes of 
No. 2 Plain, and one tube of No. 2-20 day. Remember, 
you should have at least one and one-half quarts of 
bichloride solution and the same of lysol solution. 


Page Fifty-three 



LECTURES OF INTEREST TO WOMEN 


Two quarts are better, if the containers you use 
will hold it. These solutions are used to disinfect 
the hands as well as the patient during confinement. 
It is not necessary to complete the sterilization 
of your hands until you have finished getting the 
dressings and solutions ready for use. 


Paragraph 114 

Remember, after you have sterilized the 
articles required, made your solutions, etc., be 
careful that they do not get infected by someone 
touching them, or by getting unsterilized water 
into the basin, and let us say here that many would- 
be nurses, or neighbors who come in to give a helping 
hand, have a habit of boiling water to render it 
sterile, and then putting their unsterile fingers 
into it to see if it is cool. We might also mention 
that they will do the same thing with dressings, 
sterilize them and the next minute contaminate them 
by handling them with unsterile hands. If any of 
you wish to test the temperature of the water, after 
a little experience you will be able to test same by 
putting your hand on the outside of the vessel; but 
if you cannot tell in this way, pour a little of the 
water over your hand and you can test the temperature 
of the water without infecting the sterile water. 
Never let us see or hear of any of you making such a 
mistake, that is, to boil water to render it ster¬ 
ile, then put your unsterile hands into it to test 
the temperature. 


Paragraph 115 

In the home it is always best to confine a 
patient on the kitchen table. Put the table in the 
most suitable room. It is prepared by using an or¬ 
dinary kitchen table, placing some newspapers over 
it, and putting over them a quilt folded into sev¬ 
eral layers; upon that put a few layers of paper to 
protect same, then a sheet on top of the papers; add 
to this a Kelly pad and a pillow, and we have a very 
good obstetrical operating table. The patient can 
grasp the side of the table during the pains; two 
assistants can support the limbs, and she can let 
her feet rest on the table. 


Page Fifty-four 


PREPARATION OF THE PATIENT 


Paragraph 116 

After the delivery, your patient is placed back 
into a clean bed and made comfortable. While the woman 
is in the second stage of labor, prepare the bed for 
your patient the same as you have been instructed. 
See that the linen is changed on the bed and have a 
hot water bottle placed at the foot, so as to have 
the bed good and warm. By using a table in place of 
a bed upon which to confine the patient, both physi¬ 
cian and nurse can do better work. Put plenty of 
newspapers on the floor under the end of the table, 
and a slop jar for the fluid from the Kelly pad 
to drain into. In this way you can keep everything 
very clean and sanitary. 

Paragraph 117 

You will find it very convenient in some homes 
to use the kitchen for a delivery room; then the lino¬ 
leum on the floor does not need any protection. 

Paragraph 118 

In connection with the preparation, the list 
of articles needed, and to be furnished by the 
patient for labor in the home, are as follows: 

3 Hand basins of graniteware (1 for bichlor¬ 
ide solution, one for lysol solution, and 
one for sterile water; the one used for 
sterile water can be used during the third 
stage of labor to receive the afterbirth. 

1 Ideal bed pan, and a slop jar; 

Rubber sheeting enough for the bed (a piece 
a yard square; 

20 yards bleached dairy cloth or gauze; 

2 pounds of sterile absorbent cotton; 

5 yards of plain gauze; 

1 bottle bichloride tablets (100 each small 
size, blue); 

2 medium-sized pitchers, glass or china; 

1 hot water bottle; 

4 ounces boric acid crystals; 

4 ounces of lysol; 

1 large bundle newspapers; 

1 pint of alcohol; 

Small bottle of olive oil; 

Pure Castile soap; 


Page Fifty-five 


LECTURES OF INTEREST TO WOMEN 


Plenty of towels, large and small (half a 
dozen each); 

Half dozen new sheets; 

2 Yards of muslin for abdominal binder and 
T bandage. 

Paragraph 119 

These are the things that the patient should 
have in her home, and-with this outfit you will be 
able to make the dressings. When you are engaged 
for a case, you will call at the patient’s home one 
week or so before the day reckoned for her confine¬ 
ment. You will make up your supplies and sterilize 
towels, sponges, pads, cotton applicators, sheets, 
etc., and have the complete outfit ready to use when 
needed. 

Paragraph 120 

Take a sufficient amount of one pound of cot¬ 
ton and make it into pledgets, or sponges, of con¬ 
venient size, pack into glass jars, and sterilize 
in the cook stove or gas oven. Gauze sponges can be 
sterilized in the same manner. It would be well to 
have two jars of cotton sponges and two of gauze 
sponges. 

Paragraph 121 

To make the gauze sponges, take a piece of 
gauze about one foot square and fold it with the 
edges turned in, so that it makes a sponge about 
three inches square. Take the other pound of cotton 
and make it into large vulvar pads, and cover with 
gauze, which can be wrapped up in packages of six 
and sterilized. 

Paragraph 122 

Ydu make cotton applicators by wrapping a 
small piece of cotton around the end of a toothpick, 
sterilize one dozen in a package wrapped in a piece 
of gauze. They are to be used in care of baby—for 
cleaning the nostrils and ears or applying any re¬ 
quired medication. 

Paragraph 123 

You can sterilize a bunch of newspapers by 
baking them in an oven, and they will serve for any 
purpose, for example: to wrap up basins, towels, 


Page Fifty-six 



PREPARATION OF THE PATIENT 


and sheets, that have been sterilized and to lay on 
tables and chairs to avoid marring them during 
labor. After everything has been sterilized, the 
packages are put away in a clean drawer or trunk and 
your maternity outfit contains all the needed uten¬ 
sils, such as basins, gauze, dressings, pads, 
sheets, towels, etc., already sterilized, neatly 
packed and ready for use. At the time of labor, the 
physician finds things all prepared and ready—a 
most comforting feeling. To be well prepared is 
half the battle. 

You will receive full instructions how to make 
sponges, pads, etc., when you take your training in 
that department. Now, in some cities we have con¬ 
cerns that furnish a **complete sterilized obstet-. 
rical outfit’’, and these are furnished to the 
patient direct. It will be much to your advantage, 
both financially and professionally, to operate 
your own sterilizer in connection with your private 
practice—you make up your supplies and sterilize 
them ready for use—so when the physician calls you 
on a case you can furnish the outfit yourself. You 
can also make arrangement with the Seattle Maternity 
Hospital to make and sterilize your dressings and 
ship them to you ready to use. 

Paragraph 124 

Let me give you a complete list of such in¬ 
struments and supplies that the physician’s grip 
should contain and the balance or in part be sup¬ 
plied by the patient or yourself, so that in case of 
the ordinary complications, you will know what is 
required: 

1 Kelly pad; 

Tape for tying the cord; 

1 rubber catheter No. 7; 

2 medicine droppers; 

1 ounce normal salt solutions; 

1 ounce nitrate of silver, 1%; 

1 ounce fluid extract of ergot; 

3 ampules of ergot for hypo; 

3 ampules of pituitin; 

2 small cans ether; 

4 ounces liquid green soap; 


Page Fifty-seven 


LECTURES OF INTEREST TO WOMEN 


3 ampules of sterile camphorated oil; 

3 tubes 20-day chromic catgut—No. 2; 

4 curved needles, 2 sizes (2 cutting and 2 
round) ; 

Silkworm gut (at least one-half dozen strands 
medium size); 

4 ounces alcohol; 

1 auto strap safety razor; 

1 hypodermic syringe; 

Half dozen artery forceps; 

1 needle holder; 

2 pair of scissors (1 pair straight and 1 pair 
curved, for Episiotomy); 

1 pair of Jackson retractors; 

1 uterine irrigator; 

3 ampules of adrenalin, 1:10,000; 

2 pair of vulsellum forceps; 

2 intestinal forceps for holding cervix; 

1 placenta forceps; 

1 pair of Simpson obstetrical forceps; 

1 pair of tissue forceps; 

1 pair long uterine packing forceps; 

2 broad retractors; 

1 anaesthetic mask; 

1 baby scale; 

1 lung motor; 

2 pair of rubber gloves; p 

Nail brush and file; 

1 bottle bichloride (small) tablets; 

4 ounces lysol; 

1 large solid rubber bougie; 

1 fountain syringe; 

Paragraph 125 

And for a post partum hemorrhage, you will 
need, in addition to the above, providing it is nec¬ 
essary to pack the uterus: 

One 12-yard jar of iodoform gauze; 

One 6-yard jar of same (the gauze in both jars 
is three inches wide); 

One needle for giving salt or soda solution; 
Three one-dram bottles of sterilized salt; 
Three one-dram bottles of sterilized bicar¬ 
bonate of soda; 

One tube Merck’s sterile gelatine. 


Page Fifty-eight 



PREPARATION OF THE PATIENT 


Paragraph 126 

Now, the average physician will not furnish 
you as complete a list of instruments and supplies 
as this, but you must have the following for a 
normal case: 

1 Kelly pad; 

Tape for tying cord; 

1 auto strap razor; 

Needle holder; 

Needles; 

Ligatures (both silkworm and catgut); 

Soft rubber catheter No. 7; 

Two pair of scissors (straight and curved); 
One-half dozen artery forceps; 

2 medicine droppers; 

1 ounce normal salt solution; 

1 ounce nitrate of silver, 1%; 

1 ounce fluid extract of ergot; 

3 ampules of pituitin; 

2 small cans ether; 

4 ounces liquid green soap; 

2 pair of rubber gloves; 

Nail brush and file; 

1*bottle bichloride (small tablets); 

1 hypodermic syringe; 

4 ounces alcohol; 

4 ounces of lysol; 

Fountain syringe; 

Paragraph 127 

The nurse’s grip should contain: 

One hypodermic syringe; 

Fever thermometer; 

1 pair of scissors; 

4 ounces of green soap; 

4 ounces alcohol; 

1 auto strap razor; 

2 test tubes; 

1 small bottle of bichloride tablets; 
Reagents for testing urine; 

2 ounces lysol solution; 

Fountain syringe; 

Rectal tube; 

Rubber gloves; 


Page Fifty-nine 



LECTURES OF INTEREST TO WOMEN 


Sterile gown; 

Orange sticks; 

Nail brush and file; 

1 soft rubber catheter No. 7. 

Paragraph 128 

The physician will supply you with the neces¬ 
sary instruments, or you can select them from his 
grip and sterilize them by boiling as mentioned 
above. 


Paragraph 129 

We will suppose your patient is having labor 
pains, the beginning of the first stage when you 
arrive. You will immediately ascertain the condi¬ 
tion of the bowels and note if the kidneys are 
acting, and examine the urine for albumen. If you 
have an instrument, take the blood pressure. If 
the pains are coming on regularly, and after your 
observations and examination you are satisfied that 
the patient is in labor, you should immediately 
give her an ordinary soapsuds enema, get the bowels 
to move freely, and be sure that the lower bowel is 
free from all fecal matter. It is generally neces¬ 
sary to give the second enema or even the third. 

See that the water returns perfectly clear, only 
use plain water after the firs*b enema. 

Paragraph 130 

Give your patient a shower or sponge bath. 
Remember that during the last few weeks of pregnan¬ 
cy, or just befor labor, it is not advisable to give 
a tub bath. It is better to give her a sponge or 
shower bath; then there is no danger of the water 
getting into the vagina. 

Paragraph 131 

Prepare the bed, and give the patient the 
proper external care. You will see that the bladder 
is empty and render the external parts thoroughly 
aseptic. You will do this by clipping the hair very 
close over the mons veneris, and shaving the parts 
below. Some prefer shaving the mons veneris, also. 
We do this in the hospital. Now scrub the limbs 


Page Sixty 


PREPARATION OF THE PATIENT 


above the knees and the genitalia thoroughly with 
liquid green soap, using plenty of water. Separate 
the labia and remove all the smegma and give all the 
parts a thorough scrubbing. Then wash all the 
parts off with bichloride solution, 1-3,000, and 
last with a 1-400 lysol solution. If the surround¬ 
ings are npt the cleanest, and you want to make 
doubly sure that the parts are aseptic, after 
using the lysol, wash off the genitalia thoroughly 
with 40% alcohol. 


Paragraph 132 

After this, during labor, if the parts become 
soiled, simply cleanse them with lysol solution. 
Just prepare a little of the solution—a quart is 
enough—for immediate use in some basins. Ordinary 
china or glass water pitchers, as found in the home 
are very convenient. While making these prepara¬ 
tions, the patient should be placed on a douche pan, 
or Kelly pad, in order to keep the bed from being 
soiled, or, if the pains are not too severe, all 
these preparations can be made in the bath room, 
the patient lying down in the bath tub while you are 
preparing her, having first thoroughly cleaned the 
tub with bichloride solution. Always shave your 
patient first while in bed. 

Paragraph 133 

If you have not been called to the case prior 
to the time of confinement, and you must make your 
supplies as labor progresses, and if it is only the 
beginning of the first stage, you will generally 
have several hours for this work. 

Paragraph 134 

For immediate use, take plain sterile gauze 
and cut off a piece about seven inches long (from 
the five-yard package), and place it locally over 
the parts as soon as you have rendered them aseptic. 
If the parts became soiled, which necessitates the 
changing of same, it is well to wash the parts off 
with lysol solution occasionally, in order to keep 
them perfectly antiseptic. Sterilize your rubber 
gloves by boiling and have them ready for use, so 
that if it becomes necessary for you to make a vagi- 


Page Sixty-one 



LECTURES OF INTEREST TO WOMEN 


nal examination in order to tell what time to send 
for the physician, you will be ready to do so. 

Paragraph 135 

Never make a vaginal examination unless you 
call up your physician who has charge of the case, 
and get his permission, or ask his advice. Often 
you can save the doctor hours of time and an extra 
visit. You will be taught how to make these exami¬ 
nations, and intelligently note the advancement the 
patient is making. 

The rapidity of the descent of the head may 
easily and safely be determined by pressing the 
fingers upward and inward along the sides of the 
vagina. It is an external examination, the details 
of which we will show you in a clinical demonstra¬ 
tion. 

In the meantime, prepare the bed and table, 
sterilize the dressings and get everything ready 
for the confinement. Have cold and hot sterile 
water on hand and get everything as nearly ready as 
you can, following the instructions that we have 
given you, so that you will have everything in 
readiness when the physician arrives. 


HOW TO MANAGE A NORMAL CASE OP LABOR, INCLUDING 
THE AFTER CARE. 

Paragraph 136 

We will instruct you at this time how to con¬ 
duct, or manage, a normal case of labor, including 
the after care, while the patient is in bed; what is 
known as the lying-in period: the Puerperium. 

Paragraph 137 

Now, what we mean by a normal case of labor is 
a head presentation without any complications, and 
the child and afterbirth are born at least within 
twenty-four hours from the beginning of labor and 
without any help to the uterus. Breach and face 
presentations can be considered under normal 
labors, when they terminate unaided, as they often 
do, within the twenty-four hour limit. 


Page Sixty-two 




PREPARATION OF THE PATIENT 


Paragraph 138 

You have been instructed how to prepare your 
patient, how to prepare the bed, table, solutions, 
instruments, etc., and we are sure you will not for¬ 
get in this preparation to be scrupulously clean; to 
have everything sterile and to keep everything in 
an aseptic condition, because you, as nurse, will 
be personally responsible to a certain degree if 
any infection occurs. You will be notified when 
labor begins and will go to your case several hours 
ahead of the physician. You will ascertain if the 
woman is in labor, watch how the case is progress¬ 
ing, have everything in readiness, and it is your 
duty to keep the attending physician informed as to 
how the case is advancing and to call him in due 
time. 


Paragraph 139 

LABOR is divided into three stages: 

THE FIRST STAGE is the stage of dilatation; 
that is, the dilating of the cervix; therefore, the 
first stage of labor is from the initial opening of 
the closed cervix to its full dilation. 

THE SECOND STAGE is the stage of expulsion or 
delivery of the child. It begins after complete 
dilation of the cervix and ends with the birth of 
the infant. In this stage the pains grow stronger, 
more frequent, and change in character being 
expulsive. 

THE THIRD STAGE is the stage that extends 
from the delivery of the child to the delivery of 
the afterbirth, or placenta and membranes, and the 
complete contractions and retractions of the 
uterus. 

Paragraph 140 

You must become familiar with each stage; 
know what your duties are in each case and be able 
to tell when the first stage ends and the second 
stage begins; and to know when the patient is actu¬ 
ally in labor. You have four conditions that will 
assist you greatly in deciding the last question, 
“Is the woman in labor?’’ They are as follows: 

1. When the contractions of the uterus are 


Page Sixty-three 



LECTURES OF INTEREST TO WOMEN 


painful and the pains are generally in the back and 
occur every fifteen to twenty minutes. 

2. When the head is fixed between the pains. 
Thus you can often determine by feeling the head 
above the symphysis. 

3. The show—there is almost always a mucous 
discharge from the vagina, often tinged with blood, 
at the commencement of labor. 

4. The dilatation of the cervix, especially 
the internal os. 

Now, if we consider each of these conditions 
separately, it will help you to determine if the 
woman is in actual labor, and you will be able to 
tell more from the knowledge obtained from the con¬ 
dition of the pains than the other three. 


Paragraph 141 

FIRST: When the labor sets in, the patient 
becomes aware of the uterine contractions from the 
pain they cause her. The pains usually begin in 
the back, and increase in severity until they ex¬ 
tend to the abdomen and occur every fifteen to 
twenty minutes. If you will ask your patient to 
go to bed, if she is not already in bed, you will see 
if the contractions of the uterus are really pain¬ 
ful . You will palpate the uterus gently and note 
when it hardens. Ask your patient to tell when she 
has pains. Now, if the uterus hardens and she tells 
you she is having a pain in her back at the same 
time, it is almost a certainty that she is in labor. 

Paragraph 142 

SECOND: In order to see if the head is fixed, 

use Pawlick’s grip. You will note that the head 
cannot be moved from side to side, or only just a 
trifle. The reason you cannot move the head is be¬ 
cause the lower uterine segment contracts firmly 
around it and keeps it in place. If the head is 
freely movable and the contractions are not pain¬ 
ful, the patient is not in labor. 

To employ Pawlick’s grip, face your patient, 
grasp the presenting part just above the symphysis 
—the thumb on one side of the head and the fingers 


Page Sixty-four 




PREPARATION OF THE PATIENT 


on the other. Now, with firm and gradual pressure, 
the thumb and fingers sink well down on both sides 
of the head, in normal cases, and grasp the head, 
which does not move if the woman is in labor. This 
sign is only useful in the case of a woman who has 
had children, but it is not to be used in the primi- 
para, for in these cases the. head is fixed some 
three weeks before labor, as will be demonstrated 
to you in your clinical work. 

Paragraph 143 

THIRD: To see if there is any flow, turn your 
patient on her left side and examine her carefully, 
and if blood stains with a mucous discharge are 
present and passing from the vagina, it is certain 
that the woman is in labor, especially when pains 
are present. Yet the absence of this discharge 
does not prove that the woman is not in labor. 
Sometimes there comes away, two or three days be¬ 
fore the onset of labor, mucous from the cervical 
canal, but you must not confuse this with the vagi¬ 
nal discharge. 

Paragraph 144 

FOURTH:. You will not make a vaginal examin¬ 
ation to see how dilatation is progressing unless 
instructed to do so by your attending physician. If 
it becomes necessary for you to do this, you will 
proceed as you have been instructed; that is, give 
your patient an additional external cleansing with 
lysol solution and you will also render your hands 
sterile, having sponged off the parts thoroughly. 
Have your patient lie on her back. Separate the 
parts and give them an extra sponging. Put on your 
gloves and insert the two fingers of the right hand 
into the vagina. Just before inserting the fin¬ 
gers, dip the hand with the glove on into the lysol 
solution and this will be all the lubricant that 
will be necessary. Vaseline or any other lubricant 
is rarely, if ever, needed to lubricate the fingers 
in making a vaginal examinatinon. You will note 
the amount of dilatation, the condition of the 
cervix and how far the head has advanced, and if the 
bag of waters are forming. If a vaginal examina¬ 
tion is made at the beginning of labor, you will not 


Page Sixty-five 


LECTURES OF INTEREST TO WOMEN 


be able to feel the cervix, because it will be too 
far back. During the process of labor, the cervix 
will feel as a hard ring, or band, around the bag of 
waters, and as labor advances it increases in size 
until the cervix is completely obliterated, and 
this is when the second stage of labor begins. 

Paragraph 145 

Now, to tell when the pains of the second stage 
begin, you will note they are characterized by the 
patient bearing down with each pain. Your patient 
gets red in the face, often sweats, and the pulse 
quickens during the pains. The pains last longer, 
come more -frequently and are more painful than those 
of the first stages. After a little practice, you can 
almost always tell the difference between the pains 
of the first and second stages, because in the first 
stage they are much shorter in duration, less 
violent, and less frequent, and as the second stage 
advances, the bulging of the parts occurs with each 
pain. The bag of waters generally rupture any time 
during the second stage. So you might say the time 
to send for the doctor is when the second stage of 
labor begins and there is pressure against the 
perineum. Do not wait too long to call the doctor. 
Note how long it will take him to arrive . When con¬ 
venient, it is a good plan to have the physician 
call early in the case, so he can personally note 
the patient’s condition, then return when needed 
for the delivery. It is much better that you make 
the mistake of sending for him an hour too soon than 
twenty minutes too late, because if the baby is born 
before the physician arrives, you will get your 
share of the blame. 


HOW TO MANAGE THE DIFFERENT STAGES OF LABOR. 
Paragraph 146 

FIRST STAGE: 

When you first arrive, you will ascertain if 
the patient is in labor and if so prepare her for the 
confinement. Arrange the bed and room, prepare 
the table to be used during the second stage. See 
that all supplies are ready, and plenty of hot and 


Page Sixty-six 




PREPARATION OF THE PATIENT 


cold sterile water. Get things ready that you will 
need for the baby. Sterilize the basins for the 
different solutions, for bichloride and lysol. 
Don’t forget the boracic acid solution, that you 
will need for the baby’s eyes and mouth. 

Paragraph 147 

During the first stage of labor, prepare the 
patient, see that the solutions are at hand, such 
as bichloride and lysol, have the gloves ready, as 
well as all other necessary articles for examina¬ 
tion. 

You will take an inventory and see that you 
have everything in readiness for the physician when 
he arrives, a place and articles needed to prepare 
his hands, including solutions and gloves for the 
first examination. 


Paragraph 148 

As soon as you take charge of the case, you 
should take the temperature, pulse, respiration, 
examine the urine and blood pressure, if you have 
an instrument, and keep a full record for the 
doctor’s information, using record blanks the same 
as we use here in the Hospital. 

It is not necessary for your patient to be 
confined in bed all the time during the first stage. 
You must see that she takes nourishment occasion¬ 
ally in order that she does not become exhausted, 
and in this way you will be able to keep up her 
strength. 

Paragraph 149 

As a general rule, patients during labor have 
very little desire for food, but they should be made 
to take nourishment in order to keep up their 
strength. If they go too long without food, espe¬ 
cially in prolonged cases of labor, they are apt to 
have a postpartum hemorrhage, on account of the gen¬ 
eral weakened condition. The patient should have 
food, especially in liquid form, at regular inter¬ 
vals. Ice cream is good, or anything that is nour¬ 
ishing and digestible. Sometimes patients will 
vomit, but even then they’should be given food. 


Page Sixty-seven 







LECTURES OF INTEREST TO WOMEN 


Paragraph 150 

You will select the sunniest and best room 
in the house for the lying-in period, one with 
plenty of light. It should all be arranged so you 
will have plenty of light during the night time as 
well. Remove all unnecessary furniture, have a 
cot in the room for your own use and you will make 
no mistake to have the woodwork and floor thor¬ 
oughly washed with a 1-1000 bichloride solution. 

Paragraph 151 

In some homes you will come in contact with 
ignorant relatives who will object to what they 
term as ‘‘unnecessary preparation and that the 
patient’s mother was not delivered with so much 
fuss and ado.’’ Here, a little tact on your part 
and explanation will clear the way. Do not force 
such advancements. You must educate and gently 
lead them into your way of thinking and doing. 

Paragraph 152 

If the first stage of labor is prolonged, it 
may be necessary to give an extra enema, as the 
bowels must be thoroughly emptied during the second 
stage. The patient should urinate every four 
hours, as the bladder must also be emptied at the 
beginning of the second stage. 

SECOND STAGE: 

Paragraph 153 

You will recognize the second stage of labor 
by the pains being more expulsive and more fre¬ 
quent. You will immediately see that the bladder 
and rectum are emptied. At the beginning of this 
stage your patient will in all probability feel 
more comfortable to remain in bed for a short time 
at least. During the pains she will have a desire 
to bear down and it is a good plan to have something 
for her to pull upon. 


Paragraph 154 

It is a good idea to take an ordinary sheet 
and twist it up in a sort of a roll, do this by taking 
two diagonal corners, have an assistant hold one 
and you the other; give it a whirl; then tie a knot 
in each end and place it around the rods on the foot 


Page Sixty-eight 


PREPARATION OF THE PATIENT 


of the bed. Now with the patient’s feet against 
the foot of the bed as a support, have her grasp 
the sheet just above the knots, one in each hand. 
The knots can be regulated according to the length 
of the patient. As labor advances, and you notice 
the rapidity in which the child is being expelled, 
or the rupture of the bag of waters, you will in¬ 
form the attending physician and at the same time 
get the patient on the table for the delivery. 

It is well to inform the physician when the second 
stage of the labor begins and, in that way, he can be 
prepared to answer your call when needed. Always 
remember to have a good estimate as to how long it 
will take the doctor to arrive after you call him. 
You keep him posted on any special detail. Prepare 
a place for him to sterilize his hands. Have basin, 
soap, brush and nailfile all ready as well as 
sterile gloves for first examination. Between 
the pains you will make up your solutions, and if 
you have not the instruments at hand until the 
physician arrives, you will have a basin, the dish- 
pan, with boiling water, so as to sterilize them 
quickly. Get the solutions ready, keep them warm 
during this stage and change them occasionally as 
needed; also have a little basin ready to sterilize 
the physician’s gloves for the delivery; and you 
will find that it will be of great advantage if 
possible, to take the doctor’s grip with you when 
you are first called on the case or have him leave 
it on his first visit or send it to you, then you 
can have everything ready when he arrives. Prepare 
your hypodermic and see that it is ready for use 
in case the doctor wishes to administer any 
hypodermic during this stage. 

Paragraph 155 

Place the patient on a table for delivery in 
due time, and during the second stage administer 
ether, as you have been instructed, as this will 
relieve the patient greatly of her sufferings and 
if properly administered, as you have been in¬ 
structed with other drugs, it makes labor almost 
painless. It is AMERICA’S TWILIGHT SLEEP, and, 
in our opinion it is free from all danger and harm 
either to mother or child. 


Page Sixty-nine 



LECTURES OF INTEREST TO WOMEN 


Paragraph 156 

NITROUS OXID-OXYGEN is the latest anaesthetic 
for obstetrical work, and is administered by a 
special apparatus. It is the ideal one, and when 
administered as instructed by the attending physi¬ 
cian, it gives the most satisfactory results and 
renders childbirth painless, and at the same time 
prevents surgical shock. It is worth the additional 
cost to the patient, and should be used whenever it 
is possible to be obtained. (See Painless Child¬ 
birth. ) 

Paragraph 157 

To get the best effect from an anaesthetic 
for a confinement case, it should be given at the 
commencement of each pain. Using planty of ether 
on the inhaler, instruct the patient to take a few 
deep, quick breaths and inhale all the ether she 
possibly can; then take the mask away and tell her 
to hold her breath and bear down. If the pains are 
excruciating, give her a whiff or two as the pain 
ceases, then no more until the next pain begins. 

Just as the head is being born (the attending physi¬ 
cian will instruct you when this takes place), you 
will completely anaesthetize your patient for a 
few minutes. The doctor may wish to perform epi- 
siotomy and by having your patient anaesthetized at 
this time, it prevents any pain, helps to dilate the 
soft parts by relaxing the tissues, and makes the 
delivery of the head and shoulders painless. 

Paragraph 158 

A good plan is to give the ether from an ordi¬ 
nary drinking glass. First, put in the. bottom of 
the glass a little cotton, then pour about a tea¬ 
spoonful of fresh ether on the cotton at the begin¬ 
ning of each pain, and place the glass over the 
patient’s nose and mouth. When help is scarce the 
patient can hold the glass herself; and by turning 
it upside down on the pillow, it will save the ether 
and then it will not require fresh ether each time. 

Paragraph 159 

You will sterilize your hands, so that they 
can be re-sterilized very quickly in order to give 
the physician any immediate assistance that may be 


Page Seventy 


PREPARATION OF THE PATIENT 


required. Care for the baby’s eyes and mouth as 
directed. 

Paragraph 160 

Now, let us take it for granted that you are 
unable to get the physician and the baby is born 
before he arrives. You will deliver the head and 
shoulders, as instructed in our clinical work. 

You will hold the head back until you are quite 
sure that there will be no tear, and protect the 
perineum as best you can. 

Paragraph 161 

What we want especially to call your attention 
to is the tying of the cord. 

After the baby is born, and you have washed 
out the mouth and eyes, you will gently compress 
the cord between thumb and fingers and see if it 
pulsates, do not attempt to tie it until after the 
pulsation has ceased. With the umbilical tape, or 
suitable ligature, the cord is ligated close to 
the skin margin of the navel, a distance of about 
one-half to three-quarters of an inch. It is 
important to leave as little as possible of the 
cord to be cast off, because a short stump is less 
likely to be dragged upon and easier to dress than 
if left too long. The tying must be made very se¬ 
cure. This is accomplished by tying the knot 
slowly and interruptedly giving time for the jelly 
of Wharton to escape from under the tape. 

After the first knot is tied it is well to reinforce 
the ligature by making a knot on the opposite side 
of the cord, using the same ligature, a trifle 
closer to the skin margin of the navel, leaving a 
very small portion of the cord between the two ties. 
This gives a double tie which will be a safeguard 
against any hemorrhage occurring. 

If you have a pair of artery forceps, draw 
the cord gently, yet tightly, from the vagina and 
apply the artery forceps, and clamp the cord about 
three or four inches from the vagina. Then with a 
pair of sterile scissors cut the cord close to the 
ligature, leaving about one-quarter of an inch. 

If you have not a pair of artery forceps, use the 
umbilical tape, and tie the cord at the same place 


Page Seventy-one 




LECTURES OF INTEREST TO WOMEN 


as directed to apply the artery forceps. This 
ligature keeps the blood in the placenta, which 
gives the uterus a firm body to act upon. You can 
also tell as to the advancement of the placenta, and 
when it comes down into the vagina the distance 
from the forceps, or from where the cord is tied, is 
increased as the placenta advances into the vagina, 
and is being expelled from the uterus. 


Paragraph 162 

Again, if you are so unfortunate in your nurs¬ 
ing as to be compelled to attend a confinement case 
with no physician present, and the child is born 
practically dead, you must not only tie the cord 
but treat an asphyxiated child, and it is of great 
importance to ascertain if the asphyxia is mild 
or severe. When the asphyxia is only mild, the 
simplest treatment is usually successful; if 
severe, then no time must be lost to employ effi¬ 
cient measures to cause the child to breath. 


Paragraph 163 

When you have a case of asphyxia, either 
mild or severe, you have three very important 
principles to govern the treatment. First, see 
that the air passages are clear from all mucus 
and secretions; second, maintain the body heat; 
third, supply oxygen to the blood. 


Paragraph 164 

We will suppose that you are attending a case 
of confinement, and the physician does not arrive 
in time to attend the birth, and the baby is born 
in the state of asphyxia. What are you going to 
do? Follow this routine of treatment, and keep in 
mind the three cardinal points that we have just 
given you. 


Paragraph 165 

Number 1—At first you may not know whether 
the case is mild or severe. You will clear out the 
mucus from the mouth and throat, and before tying 
the cord, let the child straddle the arm, holding 
it with two fingers on each side of the neck, and 
support it by resting the fingers on the shoulder, 


Page Seventy-two 


PREPARATION OF THE PATIENT 


letting the head hang downward. Sprinkle it with 
cold water, and slap it on the back and buttocks. 
This position will assist in clearing the air 
passages—that is the throat, mouth and nose— 
of all mucus secretions. 'Slapping and sprinkl¬ 
ing it with cold water, as directed, is all that will 
be necessary in mild cases, and if this does not 
stimulate the child to breathe, you may know you 
have a severe case of asphyxia to deal with. 


Paragraph 166 

Number 2—Imediately tie the cord, and have 
an assistant hold the child by the feet, the fore¬ 
head resting slightly on the table so as to deflex 
the chin and straighten out the trachea. You will 
shake the child gently, and place one hand on the 
chest, and the other on the back, and squeeze it 
gently, which will have a tendency to force out 
any mucus or fluid that may be contained in the 
bronchi. While the child is in this position, 
wipe out the nose, mouth and throat; then sud¬ 
denly release the pressure on the chest and, possi¬ 
bly, you can hear the air rushing in. Let us hope 
so. The compression and sudden release may be 
repeated 16 to 20 times a minute. Do not continue 
this treatment longer (more than a minute or so). 

If this fails, ^ry the warm bath. 


Paragraph 167 

Number 3.—Now while you are giving this 
treatment (No. 2), have someone get you a pan of 
warm water; place the infant in it, and at the same 
time grasp the tongue with the intestinal forceps, 
gently drawing it back and forth at the rate of 30 
to 40 times a minute. This should consume only 
2 or 3 minutes time, as the infant should not be 
kept in the warm bath longer than that time. When 
the infant is taken out of the bath, wrap it up in 
a warm blanket, and let us impress upon your minds 
the necessity of keeping the infant warm at all 
times. We don’t think this is generally appre¬ 
ciated as it should be, because exposure, if 
prolonged, only increases the shock. If treat¬ 
ment No. 3 is not successful, try No. 4. 


Page Seventy-three 


LECTURES OF INTEREST TO WOMEN 


Paragraph 168 

Number 4—After the infant is wrapped up in 
the warm blanket, take a piece of gauze, place it 
over the infant’s mouth, and blow air into the 
lungs. Do this a few times at regular intervals; 
then give a few movements of artificial respira¬ 
tion. 

Paragraph 169 

Number 5—If there is still no sign of 
breathing, use the lung motor. While you are try¬ 
ing the above treatments (2, 3 and 4), see that " 
someone is getting the lung motor ready, and put 
it into immediate use. Our experience has been 
that the lung motor is a very useful instrument 
in these cases, and will save more infants than 
any other treatment. It is very important that 
you thoroughly understand its use and be able to 
operate it correctly, and - apply it as your chief 
aid in resuscitating the child. During any of the 
treatments, if at any time the infant begins to 
breathe, all treatment should cease, because 
added treatment after this will do more harm than 
good. 

Paragraph 170 

Be sure and keep the infant well wrapped in 
the warm blankets, and keep up the use of the lung 
motor as long as there are any heart beats. If 
there is no indication of the infant’s breathing 
after an hour's treatment with the lung motor, 
there is little, if any, hope of saving it. 

Paragraph 171 

Watchful after-care is important, because 
we sometimes have a secondary asphyxia. Espe¬ 
cially is this true if the case is one *of difficult 
delivery—that is one of severe operative pro¬ 
cedure; In secondary asphyxiation the treatment 
is not at all satisfactory, because there is 
generally some trouble in the pulmonary circula¬ 
tion. When asphyxia re-occurs, the infant gen¬ 
erally dies. 

Paragraph 172 

During the second stage of labor the physi¬ 
cian may order hot towels, wrung out of lysol solu¬ 
tion and applied to the perineum. This causes a 


Page Seventy-four 



PREPARATION OF THE PATIENT 


relaxation of the tissues and assists in dilating 
the' soft parts. 

Paragraph 173 

In managing the second stage of labor, when 
the head begins to press against the perineum, it is 
a safeguard to place your hand above and on the 
uterus, and keep it there with firm pressure until 
after the child is delivered, and continue to exert 
sufficient pressure on the uterus to keep it firmly 
contracted upon the after-birth. If you are busy 
assisting the doctor, it is well for you to instruct 
one of the other attendants or nurses to do this for 
you. Keep close watch and see that they'do this 
right and that they keep their hand in the proper 
position, as you will be instructed to do. The 
uterus should be gently massaged for some time 
after the delivery of the after-birth. Be sure it 
is well contracted before applying the abdominal 
binder. Remember, you or someone else must keep a 
gentle pressure on the uterus from the time the head 
begins to press on the perineum until the abdominal 
binder is applied. 

Paragraph 174 

After the baby is delivered, and handed to 
you, you will place it in its basket on its right 
side wrapped in a warm blanket, so it will receive no 
shock, and if the mouth and eyes have not been 
washed out, this should be done with boracic acid 
solution at once. The mouth and eyes should be 
washed out while the physician is tying the cord, or 
better still, as soon as the baby’s head is deliv¬ 
ered. If possible, wash out baby’s mouth and re¬ 
move all the mucous you possibly can before it cries 
while the doctor is delivering the shoulders. 

THIRD STAGE: 

Paragraph 175 

After the delivery of the baby and you have 
placed it in it’s basket, assist the doctor in 
the care of the patient in the delivery of the 
placenta, and assist in any repair work that 
may be necessary. It may be necessary to make up 
fresh solutions, especially the lysol. After the 
after-birth is delivered, you will watch the 


Page Seventy-five 




LECTURES OF INTEREST TO WOMEN 


uterus or you see that someone present assists 
you to do this. Be careful to instruct them how to 
hold the uterus and watch them very closely to see 
that they do as you tell them. After the de¬ 
livery of the after-birth, it may be necessary for 
you to prepare the hypodermic of ergot, or ad¬ 
minister ergot by the mouth, as directed by the 
attending physician, as during this stage you 
will be ready at all times to comply with his de¬ 
mands. Make yourself useful by being quick to 
anticipate his needs. If there is any repair 
work to be done, place a clean towel on the Kelly 
Pad over the soiled one, and sterilize your hands. 
The doctor needs your help and assistance during 
the repair work. Your duty is to sponge the parts, 
thread the needles with the silkworm catgut suture, 
plain catgut or chromic catgut, as he may direct. 
After the stitches are in place, providing there 
were lacerations needing repair, you will clean the 
patient thoroughly, using lysol freely, remove the 
Kelly Pad, put on a liberal supply of sterile per¬ 
ineal pads and abdominal binder as directed and 
return your patient to bed, which has previously 
been prepared, so that she may have the desired and 
needed rest. 


Paragraph 176 

After you have placed the baby in its basket, 
inspect the cord occasionally to see if there is any 
hemorrhage and, if you notice the slightest amount 
of oozing from the cord, call the physician’s at¬ 
tention to it at once, or retie the cord. 


Paragraph 177 

You will use a sterile basin (the one that 
contains the sterile water, emptying it first), to 
receive the after-birth. After it has been deliv¬ 
ered, the doctor may have you give the patient a 
dose of ergot, one dram (one teaspoonful) of the 
fluid extract by mouth or ICc. Ampoule hypodermic¬ 
ally. Always give hypodermic of ergot deep into 
the muscles of the leg, or thigh. Some doctors give 
ergot as a general routine. Others do not. We 
think best to give it and be on the safe side. 


Page Seventy-six 



PREPARATION OF THE PATIENT 


Paragraph 178 

If there is any laceration, or if episiotomy 
has been performed, you will supply the doctor with 
such instruments and suture material as he may 
direct, and it will assist him greatly if you render 
your hands sterile and give him the necessary as¬ 
sistance while doing the repair work. 

Paragraph 179 

Use lysol solution freely and wash off the 
parts. Place a clean, sterile towel under the 
patient. Do not remove the Kelly pad until all 
suturing is completed. 


Paragraph 180 

After the delivery of the after-birth and when 
the parts, if lacerated, have been repaired, you 
will clean your patient by washing the parts thor¬ 
oughly with lysol solution, remove the Kelly pad 
and turn her partially on the side; wash and dry the 
buttocks, put on pads and the abdominal binder, pro¬ 
viding the uterus is well contracted. Have a suf¬ 
ficient supply of perineal pads to catch the dis¬ 
charge, because there is more or less flow the first 
few hours after delivery. 

Paragraph 181 

In putting on an abdominal binder, you will 
begin to pin it from above, downward, very snugly 
and place a pad just above the uterus. If there 
happens to be a clean roller towel, roll it up and 
place it above the uterus in the form of a half 
circle. This will assist in holding the uterus in 
position. With the binder and pads applied as 
directed, holding the pads on with a T binder, the 
patient is ready to be returned to her bed. 


CARE OF THE PATIENT AFTER CONFINEMENT: 

Paragraph 182 

The physician in charge of the case will 
make his first visit within fourteen to eighteen 
hours after the birth of the child and will make 
daily visits for six days, and then every other day 


Page Seventy-seven 





LECTURES OF INTEREST TO WOMEN 


until the patient is able to sit up. The principal 
conditions which you should keep a record of, and 
report to the doctor at each visit, relative to 
the mother, is the temperature, pulse, height of 
the uterus, the lochia, the breasts, bowels, the 
urine, diet, amount of sleep; as regards the baby, 
condition of the bowels, action of the kidneys, 
nursing, its weight, cry, the navel, the eyes, 
color of skin. It is the nurse’s duty to be thor¬ 
oughly familiar with all of these conditions, 
especially in normal cases. Then she will be 
able to report any abnormal conditions to the at¬ 
tending physician. We will therefore consider 
at this time ,somewhat in detail the points of 
interest just mentioned in regard to care of the 
mother. 


Paragraph 183 

1. TEMPERATURE: During the first twenty- 
four hours after confinement, the patient’s tem¬ 
perature is very likely to rise. As this is an 
unstable period, the temperature curve will vary 
and has little, if any, significance, but if the 
temperature rises above 99 degrees Fahrenheit, 
after the first twenty-four hours, a cause must be 
ascertained and you will report the case immedi¬ 
ately to the physician. So remember that a tem¬ 
perature above 99 degrees indicates some abnormal 
condition. When the temperature is above 99 
degrees see that the bowels move regularly. Often 
absorption from the intestinal tract will cause 
an abnormal temperature. We think that an ex¬ 
cessive secretion of milk will also cause the 
temperature to rise. 


Paragraph 184 

2. PULSE: What is said of the temperature 
can also be said of the pulse. That is, it may vary 
during the first twenty-four hours, but after 
that time, if it is over 90 beats per minute, we 
have an abnormal condition to contend with. If 
the pulse is over 100 after delivery watch for 
hemorrhage. Also remember that the, temperature 
should remain at, or below, 99 in all normal cases. 
Nervous conditions will often increase the pulse 


Page Seventy-eight 



PREPARATION OF THE PATIENT 


rate and temperature may rise in such cases, if 
the nervous condition is prolonged for any length 
of time. With these nervous patients, the pulse 
rate will rise when you go into the room, but falls 
as you retire, or when she gets accustomed to your 
presence. Friends and relatives visiting the 
patient will often produce the same conditions. 
Therefore, a great deal of judgment should be 
exercised in allowing visitors to see a nervous 
patient. 

Paragraph 185 

3. HEIGHT OF THE UTERUS: The tissue of the 
uterus itself, owing to the contraction and re¬ 
traction caused by pregnancy and the termination 
of the confinement, is quite pale and anaemic. 

The muscular fibers of the uterus have been starved 
and hypertrophied during pregnancy and they now 
undergo fatty degeneration and atrophy to the size of 
ordinary muscular fibers. At least six weeks is 
required, in normal cases, for the uterus to re¬ 
gain its normal size, and at that time it should 
be just a little larger than the original virgin 
uterus. Generally at the end of the two weeks, 
the time the patient is leaving her bed, the uterus 
should be once more in the pelvis. 

The rate that this degenerative process 
takes place varies greatly in different cases, 
and it is immaterial as to how high the uterus 
should be on any given day. It is necessary to 
know that the process is gradual, that the uterus 
becomes smaller each day, and that it should be 
massaged gently during the patient’s daily morning 
care. You will note if there is a sudden dropping, 
or any rapid change of the position of the uterus, 
such as backward, or forward, and report the same 
to the physician. 

Paragraph 186 

4. THE PERINEUM: The perineum and parts 
should be kept'clean by sponging them off thor¬ 
oughly twice a day with lysol solution and in case 
there are any stitches, the parts should be irri¬ 
gated with lysol solution (one teaspoonful of 
lysol to the quart of sterile water) by pouring it 


Page Seventy-nine 


LECTURES OF INTEREST TO WOMEN 


out of a pitcher after every time the kidneys act. 
In sponging off the parts, which should be done 
twice a day, or as often as soiled, the strokes 
should always be down in the direction of the rectum, 
so as to prevent any discharge from coming in con¬ 
tact with the perineum or adjoining parts. This 
refers to external cleanliness only. Douches are 
not required, nor allowed, in normal cases, either 
before or after labor. 

Paragraph 187 

5. THE LOCHIA: The discharge, or lochia 
from the vagina, is the fluid that oozes prin¬ 
cipally from the placental site, where it is at¬ 
tached to the uterine wall. Some of it, also, comes 
from the walls of the uterus and from laceration 
of the cervix, vagina, or perineum. For the first 
three or four days, this discharge is largely 
bloody, and from the fourth to the seventh day it 
becomes white, and it should practically stop at 
the end of two weeks. 


Paragraph 188 

Now, as the uterus is returning to its normal 
size by the process just mentioned, the important 
point for you to notice is the gradual change in 
the character and amount of discharge from day to 
day, rather than the exact nature on any particular 
day. So you see there is a gradual change taking 
place in the uterus, as well as in the appearance 
and composition of the flow. 

Paragraph 189 

The lochia, or discharge, at all times, in 
normal cases is free from any pathogenic germs and 
has a peculiar odor, but not what we term foetid. 
You, as a nurse, will look for blood clots and 
pieces of membrane in the lochia and when present 
it should be recorded and same reported to the at¬ 
tending physician. The perineal pads should be 
changed as often as soiled. 

Paragraph 190 

6. THE BREASTS: The breasts, and nipples 
having had the proper care during pregnancy are 


Page Eighty 



PREPARATION OF THE PATIENT 


* 

in normal condition for the infant to nurse. The 
first three days, the breasts contain a yellow 
fluid called colostrum. The milk does not appear 
until about the third or fourth day. The nipples 
should be cleansed with a sterile saturated solution 
of boracic acid, using a sponge or absorbent cotton, 
and they should be wiped off thoroughly before the 
baby nurses, as well as afterwards. This should 
be done regardless of any treatment given to the 
nipples. The nipples should be kept scrupulously 
clean. 


Paragraph 191 

Before the infant is put to the breast for the 
first time, the breast and nipples should be rend¬ 
ered aseptic. After the mother has had a good rest 
—-say six to eight hours after delivery—you will 
prepare the breasts for nursing. Wash them gently, 
but thoroughly, with tincture green soap and water, 
then with bichloride solution 1-4000, which is 
allowed to dry in; then wash off with alcohol, and 
lastly with sterile boracic acid solution. Place 
over each nipple a piece of sterile gauze, which is 
held in place by a loose breast binder, just tight 
enough to keep the breasts from sagging. In a short 
time after this the baby is put to the breast. 


Paragraph 192 

Before and after each nursing, the nipple is 
washed with a sterile saturated solution of boracic 
acid poured fresh from a bottle and not kept in an 
open glass. It is best to apply the solution 
freely, using sterile gauze sponges. Do not let 
your unsterilized fingers come in contact with 
the nipple. If you use sterile cotton sponges in 
place of gauze, you must be careful not to touch 
the cotton sponge on any part that comes in contact 
with the nipple. Do not use gauze or cotton sponges 
a second time. At the first indication of a sore 
nipple, wash off the nipple after each nursing as 
usual with boracic acid and apply alcohol freely, 
then dry the nipple and apply castor oil and bismuth 
subnitrate, equal parts. 


Page Eighty-one 






LECTURES OF INTEREST TO WOMEN 


Paragraph 193 

If the nipples should crack and become sore, 
they should receive special attention. Often the 
nipple shield must be used to prevent the child 
from irritating the nipple each time it nurses. 
Often all that is necessary is to apply equal parts 
of castor oil and bismuth subnitrate. If this does 
not affect a cure, apply, after each nursing, 
tincture of benzoin compound to the nipple, using 
a camel’s hair brush, wash them off with 95% 
alcohol each time before applying the bezoin com¬ 
pound. If the cracks in the nipples become deep 
and are slow to heal, they generally become quite 
painful and it is necessary to heal them up. as 
rapidly as possible. If the deep cracks are 
touched up with a 4% solution of nitrate of silver, 
using an applicator, it will hasten matters. If 
these cracks are allowed to remain open for any 
length of time, there is danger of infection 
getting into the breasts and causing serious trou¬ 
ble, as this is the avenue in which breast infec¬ 
tion takes place. It is a good plan to clean the 
cracks out and disinfect them with alcohol before 
applying the silver solution; see that they are 
perfectly dry before using the nitrate of silver. 

Paragraph 194 

Babies should nurse first one breast and then 
the other. Before the baby nurses, after applying 
medication of any kind, on account of sore nipples, 
let us repeat that they should be washed, before and 
after nursing, with the boracic acid solution. When 
the breasts become filled with milk and become en¬ 
gorged, they should be bandaged and held in posi¬ 
tion by a properly applied bandage. The best ban¬ 
dage to use is the ‘‘Boston Lying-in Bandage.’’ 

You will be personally instructed how to apply this 
bandage. It is done in the following manner: 

Paragraph 195 

Take a towel, or anything suitable like 
muslin, and fold it so that it is about six or eight 
inches wide. Put it around the patient, next to the 
skin, and fold in the ends so that the folded edge 
comes within an inch and a half of the nipple when 


Page Eighty-two 


PREPARATION OF THE PATIENT 


tlie breast is well lifted up on the chest. Now, take 
another piece of muslin about nine inches wide and 
long enough so that when it is doubled it will 
extend over several inches from one end of the 
binder to the other. Now, fold it lengthwise in 
three equal layers, and again fold this narrow 
strip in the middle so as to form a V. The straight 
edge under the V is placed even with one end of the 
wide binder and securely pinned, including all 
layers of the binder, as well as the narrow strips 
and the point of the Y. Now, bring the narrow 
strips across the chest, one below the breast and 
one above.- Have the patient, or an assistant, hold 
the breasts while you pin the two strips to the end 
of the wide bandage, make them form a Y and pin the 
same as at the folded end. A safety pin can be used 
to hold the narrow strips between the breasts. Sus¬ 
penders can be used to hold up the narrow strips; 
cross the straps in the back before pinning them to 
the wide binder that reaches from one breast to the 
other. This bandage is very effective. It does 
not cover up the nipple and keeps the breast in an 
upright and natural' position and exerts pressure 
equally in all directions and does not need to be 
removed or changed when the baby nurses. The wide 
binder at the back and the narrow strips in front 
can be pinned to the abdominal binder. This keeps 
both the breast bandage and abdominal binder in the 
correct positions. 

• Paragraph 196 

ENGORGED BREASTS. If the engorged breast be¬ 
comes filled with milk to the point of distress, the 
badahge should be applied, as directed, and as a rule, 
if left alone, the simple engorgement will gradually 
disappear and the nursing is not interfered with. 
When the engorgement is intense, with an excessive 
amount of milk, give one ounce of saturated solution 
of Epsom Salts each morning. Allow very little liquids 
by mouth. Put the breast at rest by applying the 
binder, and lengthen the periods between nursings. 
If the pain is severe, apply ice bags, or hot packs 
of boracic acid solution may be used. The use of the 
breast pump and massage is not to be recommended 
except in extreme cases. Many condemn the use of 


Page Eighty-three 


LECTURES OF INTEREST TO WOMEN 


the breast pump, as it stimulates the activity of 
the breasts. Neither the breast pump or massage 
should be used if there is any inflammation present. 

Paragraph 197 

It is quite an art to scientifically and ef¬ 
fectively massage a breast, without causing any bad 
after effects, and you will have personal instruc¬ 
tions in your hospital practice with actual cases to 
work on. We want you to become experts in the care of 
the breasts. 

If it becomes necessary for you to massage 
them you will first sterilize your hands and anoint 
the breast with sterile olive oil. The first motion 
is one of even compression of the whole breast. Both 
hands are spread out as evenly and smoothly as pos¬ 
sible over the breast and firm compression is ex¬ 
erted against the chest, holding the breast, as it 
were, in the palms of the hands. 

Paragraph 198 

The blood and lymph are thus pressed out and 
away from the gland. On removing the fingers, one 
may see depressions in the surface. This pressure 
is not painful, but to the contrary. After this even 
pressure has been practiced for a few minutes and 
all the glands covered, gentle circular strokes are 
made with four fingers of the right hand from the 
nipple towards the chest to the periphery of the 
gland. The four fingers make a complete circle as 
they pass down along the side of the' breast to its 
edge, pressing harder as they go away from the 
nipple. The breast is steadied by the other hand. 

After circling the breast two or three times, 
the third motion is applied. The one hand steadies 
the breast, while four fingers of the other hand 
wipe the breast from below upwards towards the 
nipple. This will cause the milk to flow out of the 
nipple if any is formed. If at any time the massage 
becomes too painful, compress the breast as direct¬ 
ed at first, which will relieve the pain. When the 
breasts are properly massaged, the patient will 
feel much relieved, and this will be true if no milk 
comes out of the nipple. After massaging, the 
breasts should be bandaged smoothly and tightly. 


Page Eighty-four 


PREPARATION OF THE PATIENT 


Paragraph 199 

CAKED BREAST is an altogether different 
condition, and should not be massaged, but the 
binder should be put on tight and should hold the 
breast in position firmly, yet gently. So the 
treatment of the caked breast, we might say, is to 
leave it alone, because as a general rule manipula¬ 
tion only makes bad matters worse. Of course, your 
physician will give speqial instructions for you to 
follow, both when the breast is engorged or caked. 

Aside from the engorged, caked breasts and 
sore nipple there are other conditions regarding 
the care of the breasts and milk supply, which we 
will consider at this time. 

Paragraph 200 

DRYING UP THE MILK. Suppose it is necessary 
to dry up the milk on account of death of the infant 
at term, premature birth, still born, or in cases 
where the milk does not agree with the infant, the 
following is the quickest and simplest way to stop 
the milk secretion: 

Restrict all liquids as much as possible from 
the diet and give each morning two or three teaspoon¬ 
fuls of Abbott’s Saline laxative dissolved in half 
a glass of water, or any saline cathartic in small 
doses, like Epsom Salts or Citrate of Magnesia. Apply 
a firm breast binder, not the Boston Lying-in ban¬ 
dage but one that covers the entire breast, and then 
the breasts are left absolutely alone. The use of 
the breast pump or massage is not to be recommended 
because it only stimulates the glands to further 
action. Drugs are of no value. If we wish to dry up 
the milk at the time of weaning the baby and they 
become engorged or caked, we give the same treatment 
as we do for engorge^ or caked breasts that occurs 
at the beginning of nursing. 

Paragraph 201 

CONTINUOUS FLOWING OF THE MILK SECRETION. In 
some cases we find there is a secretion from the 
breasts occurring irrespective of nursing and per¬ 
sisting after nursing. It is called Galactorrhea. 
It is a very rare condition and the causes are not 


Page Eighty-five 



LECTURES OF INTEREST TO WOMEN 


well known. It occurs more frequently in nervous 
women. One or both breasts may be affected and the 
flowing may be intermittent. It may follow abor¬ 
tions or full-term labors; the flow may be very 
slight or very profuse and may continue for some 
time. Cases are recorded to have lasted for years. 
It affects the general health of the patient. When 
this condition exists the breast binder may be 
applied, and often when menstruation is absent and 
returns, the milk secretions generally stop. Such 
conditions should be reported to the attending 
physician, as the flowing may be caused by an in¬ 
flamed portion Of the breast that would need sur¬ 
gical attention. 

Paragraph 202 

ABNORMAL MILK. Abnormal milk we would term 
as milk of the mother which is normal in quantity 
and quality, yet does not agree with the child. It 
seems to act as an intestinal irritant and deaths 
have been reported as a result of an infant nursing 
such milk. It is generally found in nervous women 
and the higher classes. The child will refuse the 
breast, will vomit the undigested milk, which is 
often accompanied with diarrhoea and sometimes 
fever. Strange as it may seem, sometimes the child 
will refuse one breast and accept the other. When you 
have a case of this kind where the baby is very fret¬ 
ful, does not sleep well, and the milk does not seem 
to agree with the child, causing a distended abdomen, 
colic with green, acrid stools, you should discon¬ 
tinue the nursing for 38 to 48 hours and feed the 
child on a substitute of modified cow’s milk or 
barley water and irrigate the bowels once a day with 
normal saline solution. Empty the breasts regu¬ 
larly with the breast-pump and at the end of two 
days another trial is made of the mother’s milk. 

For the first few nursings do not allow the infant 
to nurse too freely, give part barley water. If the 
milk again causes intestinal disturbances to the 
child, then a wet nurse must be secured, or it must 
be given artificial feeding, that is, modified 
cow’s milk. It must be remembered that illness of 
the mother affects the milk, causing diarrhoea and 
often convulsions and even death of the infant. 


Page Eighty-six 



PREPARATION OF THE PATIENT 


Paragraph 203 

LACK OF MILK. One of the most common com¬ 
plaints of nursing mothers, you will find, is 
scarcity or lack of milk, and when this exists we 
call it Agalactia. 

The causes of deficient milk secretion are 
general weakness or ill health of the.mother, mal¬ 
formations or diseases of the nipples, lack of 
proper stimulation of the breasts by weak infants 
—-women with the first child after thirty-five are 
seldom able to nourish the infant—starvation and 
wasting diseases will affect the normal amount of 
milk. Worry, fright, pain and anger will tempo¬ 
rarily stop the flow of milk, lack of love for the 
child may reduce the amount. 

Paragraph 204 

A large breast does not mean a good supply of 
milk, small.breasts with thin skin usually give 
plenty of milk, and when there is a lack of milk 
supply we first notice the distress of the child— 
its loss in weight, there is pain in the breasts and 
absence of secretion, the child being unsatisfied 
with the nipple. It may nurse for a short time but 
finding nothing there it will refuse it and cry. 

We do not massage the breasts in the same way to 
increase the milk as we do when the breasts 
are engorged. To increase the milk we wish to 
stimulate the glands. This is done by raising the 
.whole breast from the chest-wall and working it 
gently between the fingers. Care should be taken 
not to bruise the delicate organ, as an abscess may 
result. The gland is then held against one hand, 
while the tips of the outspread fingers of the other 
hand make circular movements all around its 
periphery. The best stimulant for the secretion of 
milk is the nursing of a vigorous infant. Cool 
baths and general massage with coarse towels are 
beneficial. 

Paragraph 205 

■ 7. THE BOWELS. During the lying-in period, 
patients are generally troubled more or less with 
constipation. On the morning of the third day give 
your patient an ounce or an ounce and a half of • 
castor oil. This is best given in orange juice. 


Page Eighty-seven 




LECTURES OF INTEREST TO WOMEN 


Take the juice of half an orange, place it in a glass 
and see that the sides of the glass are thoroughly 
moistened with the orange juice, and then pour the 
oil in the center, not allowing it to touch the 
sides of the glass; then put a little orange juice 
on top and this makes it very palatable. A little 
bicarbonate of soda may be added to the orange juice, 
if so desired, before the oil is poured into the 
glass to make it more palatable. When the bowels 
are ready to move from the effect of the oil, an 
enema should be given. 

Paragraph 206 

When necessary to keep the bowels regular 
after taking the oil, give the patient one or two 
teaspoonfuls of Kasagra each evening, or, in place 
of Kasagra, give one-half to one ounce of Phillip’s 
Milk of Magnesia (either one will do), and if they 
do not move regularly each morning, an enema should 
be given. 

You will find that castor oil, Kasagra or 
milk of magnesia, given to the mother, rarely has 
any effect on the child. In normal cases, where you 
have no complications, there is no objection; in 
fact, we recommend letting your patient get out of 
bed and use the slop jar during the movement of the 
bowels, especially after the third day, that is, 
when the bowels move after giving the oil. The 
bowels can be emptied much better in this way, and 
it has a tendency to assist the uterus in expelling- 
any clots, if the same should be present. Care 
should be taken to see that the slop jar is perfectly 
clean. Before using, better wash the top off with a 
bichloride solution, 1-2000, then you will be sure 
of no infection. 

Paragraph 207 

8. THE URINE: If the patient does not urin¬ 
ate within ten to twelve hours after confinement, 
she should be catheterized and the bladder emptied. 
Once is generally sufficient, but the bladder must 
be emptied at least twice in the twenty-four hours, 
and it is better to have it emptied three times, or 
every eight hours. Avoid using the catheter as much 
as possible, for there is danger of infection and a 


Page Eighty-eight 



PREPARATION OF THE PATIENT 


woman is liable to get the catheter habit. Some¬ 
times a patient must be catheterized during the 
entire lying-in period, but such cases are rare. 

Paragraph 208 

You must be very careful not to let the urine 
accumulate and distend the bladder. If such occurs, 
you will feel a tumor forming in the lower part of 
the abdomen. This you must always watch for, be¬ 
cause it would lead to the paralysis of the bladder 
wall, and often to chronic inflammation of the 
bladder. Remember this, that when your patient is 
continually urinating, a little at a time, that the 
bladder is becoming filled with urine and should 
receive attention and should be catheterized, as 
the bladder should not be allowed to become dis¬ 
tended. 

Paragraph 209 

Before the catheter is resorted to, try the 
following: 

1. Place the patient on a bed pan containing 
steaming hot water and leave her alone. 

2. Allow water to run in wash stand, if it is 
in the same room. 

3. Lay a large pad, dripping with warm ster¬ 
ile water over the pubis. 

4. Place a hot sterile fomentation over the 
bladder. 

5. Give very warm enema of normal saline 
solution. 

6.. Gentle pressure on the bladder may start 
the flow. 

7. Let the patient sit up on the pan, this 
being less dangerous than catheterization. 

Remember that many persons cannot urinate in 
the presence of another. 

Paragraph 210 

If the bladder must be catheterized, you must 
be very careful in your work, so as to not cause any 
inflammation of the bladder, as is often the case. 
In order to be on the safe side, it will be wiser to 


Page Eighty-nine 



LECTURES OF INTEREST TO WOMEN 


have the attending physician do it himself the first 
time. It is your duty to notify the physician that 
your patient cannot urinate before you do anything, 
and you should get instructions direct from him. 

Paragraph 211 

To catheterize a patient you will place her 
on a clean bed pan under good light, having first 
sterilized a soft rubber catheter No. 7. Make up a 
small amount of bichloride solution 1-3000 and a 
lysol solution, one teaspoonful to the quart. 
Sterilize your hands and sponge the vulva generous¬ 
ly with bichloride solution, then with the lysol. 
Wipe out the mouth of the urethra with a cotton ap¬ 
plicator, after having dipped it into the lysol 
solution. With the urethral opening in full sight 
the catheter (after being first lubricated with 
sterile glycerine) is gently passed into the bladder 
and the urine collected in a clean vessel for in¬ 
spection. If the catheter should enter the vagina, 
as it is liable to do on account of the bruised and 
swollen condition of the parts, another catheter 
should be used, or the first one re-sterilized. 

Paragraph 212 

9. DIET: Immediately after labor a patient 
not only needs sleep but nourishment as well; 
some patients will prefer hot liquids, while 
others will enjoy cold drinks like buttermilk 
or iced tea. Iced champagne is a good stimulant, 
and frequently allays gastric irritation quicker 
than any other medication. Raw milk with lime 
water is also indicated. Various meat broths are 
to be recommended. 

Paragraph 213 

The first two or three days, until the 
bowels move, the diet should be very light. Soup, 
broth, milk, toast, tea, and coffee (not too 
strong), and crackers should constitute the food 
given during this time. After the bowels have acted 
freely from the effect of the oil, you can give your 
patient with safety a regular diet, and she may have 
almost anything she can digest, such as rice and 
barley in soups, cereal foods, steaks and chops 
after the fifth day, eggs, chicken, squab, light 


Page Ninety 


PREPARATION OF THE PATIENT 


puddings, blanc mange, baked apple, jellies, fresh 
vegetables, ice cream in summer, and stewed fruits, 
such as dried prunes, apples and pears. Serve three 
meals a day. Give a glass of milk at 10 A.M. At 
three in the afternoon, give a cup of chocolate, or 
egg nog. After the last nursing at 10:00 o’clock, 
or midnight, give a glass of hot milk or malted milk. 
If malted milk is objected to, the following is very 
palatable. 

Malted milk—2 teaspoonfuls', 

Powdered chocolate (not cocoa)—1 teaspoonful; 

Cream—5 teaspoonfuls; 

Hot water—2/3 of a cup. 

Paragraph 214 

For the morning nourishment at 10 in the morn¬ 
ing or at 3 in the afternoon a wine glass or two of 
Imperial wine will be of great value, especially if 
there is a scanty flow of milk. The wine can also be 
given with meals. The liquids mentioned to be 
given between meals can be omitted in many cases, 
as they will not be required or desired by the 
patient. 

Paragraph 215 

If the breasts are engorged, do not give any 
liquids, ‘or restrict them to only a small amount. 

Your patient should not be allowed to eat so 
much that it will give her dyspepsia, as no patient 
in bed without exercise can properly consume the 
same amount of food as when up and around. When a 
patient eats too much it will cause headaches and 
gas and the patient becomes languid. 

Paragraph 216 

The patient should take a great deal of time 
in eating and should masticate the food thoroughly. 
It is not so much what she eats as the way she eats 
it. Give her plenty of fluids with her meals, and 
it is a good plan to give her a glass of water early 
in the morning before breakfast and another glass 
at bedtime. Throughout the puerperium see that the 
patient drinks pure water freely. 

After the second week, when the patient is up 
and about, a general and more liberal diet is al¬ 
lowed. 


Page Ninety-one 


LECTURES OF INTEREST TO WOMEN 


Let us, while we are speaking about the diet, 
during the lying-in period, also include the diet 
during the entire nursing period. 

Paragraph 217 

To regulate the diet of a nursing mother re¬ 
quires more or less attention. We must take into 
consideration a woman’s former habits, and be 
governed by them in prescribing her diet. 

In selecting a diet for a nursing mother it 
is well to give that which somewhat harmonizes with 
what the woman has been accustomed to before her 
confinement. 

Paragraph 218 

Fischer, in his late work, gives the following 
menu for breakfast, lunch and dinner: 

BREAKFAST, 7 to 8 A.M. 

Hominy and milk, farnia and milk, rice and 
milk, oatmeal and milk, germea and milk, cream of 
wheat and milk, some stewed prunes figs or peaches, 
stewed apples, oranges, grapes, soft-boiled eggs, 
eggs on toast, poached eggs, coffee and milk, toast 
and butter, stale bread (2 days old) with butter. 

Paragraph 219 

LUNCH, at Noonday, 12 to 1 P. M. 

Some soup made from meat, either beef, veal, 
mutton, lamb or chicken, containing also some rice, 
barley, farnia, sage or hominy; it should not be too 
highly seasoned, and should not be strained. 

Fish, boiled or fried, and all shell fish, par¬ 
ticularly oysters, are very nutritious during the 
nursing period. 

If the appetite warrants it, then a piece of 
steak or chop, roast beef, chicken (white meat only) 
or raw chopped meat, with bread and butter, is very 
nutritious. 

Paragraph 220 

DINNER or EVENING MEAL, 6 to 7 P.M. 

A bowl of oatmeal gruel, stewed oysters, a 
drink of milk, farnia pudding, rice pudding, corn- 


Page Ninety-two 




PREPARATION OF THE PATIENT 


starch padding, junket, cup of tea, eggs and meat, 
if in the habit of eating it in the evening. 

Now from this menu, such foods can be ordered 
that will satisfy your patient’s likings, but it 
must be remembered that there are certain foods that 
should be avoided, and not included in the menu, such 
as onions, garlic, cabbage, cauliflower, candies, 
too much sweets, large quantities of potatoes, butter 
and fat only moderately, and rich salad dressings 
with oils, highly seasoned dishes, spiced sauces, 
pickles, etc. They all affect the milk , imparting 
to it a bad taste, and at the same time causing the 
baby to have the colic. 

Paragraph 221 

While there are certain foods a woman should 
not eat while nursing a baby, there are also certain 
drugs that she should not take, like rhubarb, senna 
castor-oil, Rochelle and Epsom salts, arsenic, 
iodine, bismuth, iron, mercury, salicylic acid, 
iodides and bromides, as well as opium and morphine. 
All these will affect the infant when taken by a 
nursing mother. Neither should we give cocaine, 
chloral, atropine, digitalis, antipyrin and hyoscy- 
amus. All have a very bad effect, and are rarely, if 
ever, prescribed to a nursing mother. 


Paragraph 222 

10. SLEEP: After the confinement, when your 
patient has been put to bed, the first thing that 
she needs is rest and a good sleep. Often the first 
night after the confinement, she may not rest well, 
but the following night,, or day, she should sleep, 
if possible, without a hypnotic. Remember that a 
patient who does not sleep presents serious compli¬ 
cations, because the absence of sleep is the fore¬ 
runner of puerperal insanity or a symptom of infec¬ 
tion. Remember that the lying-in patient must have 
sleep and rest, especially at night; therefore, it 
is a wise precaution to take the baby out of the 
room at night so that the mother can have her needed 
rest. 

Paragraph 223 

After the confinement, the patient should go 


Page Ninety-three 



LECTURES OF INTEREST TO WOMEN 


no longer than twenty-four hours without sleep. At 
the end of this time, if your patient has had no real 
good rest, or sleep, give her from 7 to 10 grains of 
veronal. It is the best hypnotic we have for this 
class of cases, as it leaves very little, if any, 
after effects. So remember the importance of im¬ 
mediate sleep and rest after the confinement, and 
you will see that your patient gets this needed sleep 
and rest. If the baby annoys the mother during the 
day, do not keep it in the same room. You should 
make a record of the number of hours your patient 
sleeps and report the same to the physician. 

Paragraph 224 

11. THE ROOM: Both mother and infant require 
fresh air. The windows should be kept open night 
and day, and impure air should not be allowed to 
accumulate in the room. The temperature of the room 
should remain the same night and day as nearly as 
possible. The room should be cheery and refreshing. 
There is no reason for having the blinds down, ex¬ 
cepting when your patient wishes to sleep. She is 
not to be treated too much as an invalid. 

Paragraph 225 

12. DAILY CARE: You will give your patient 
each day her daily care. Give her a sponge bath, 
change the bed linen, arrange her toilet in general, 
and make her comfortable for the day. At this time 
you will knead the uterus;, note how it is contract¬ 
ing, change the abdominal binder, adjust the 
breast binder, and examine the nipple. The best 
time to fix up your patient is just after the nine 
o’clock nursing. Then after you give her nourish¬ 
ment at 10 A.M., she can have a nap. 

Paragraph 226 

13. VISITORS: The patient may see her near 
relatives, if her case has been normal and she is 
not nervous. The husband and near relatives are the 
only ones who should be allowed in the lying-in 
room during the first three days. Keep other visit¬ 
ors and relatives out, and it is a good plan not to 
allow too many visitors at any time. Do not allow 


Page Ninety-four 



PREPARATION OF THE PATIENT 


anyone to handle or take up the baby, and do not 
allow it to be handed from one to the other, or be 
kissed by friends and relatives. 

Paragraph 227 

14. AFTER PAINS: Some women suffer more or 
less with after pains, and they are often caused by 
clots forming in the_uterus. Massage of the uterus 
will often cause them to be expelled. When the 
after pains are so severe that the patient cannot 
rest, it is necessary to give something in order 
that your patient may secure the required sleep. 
Codine, in half grain doses, given every three or 
four hours for two or three doses, will generally 
control the pain. Give as few doses as possible. 
Sometimes it may be necessary to administer a hypo¬ 
dermic of morphine from 1/8 to 1/4 grain doses. One 
dose will generally be sufficient, and if clots in 
the uterus are the cause of the after pains, the 
administration of 20 to 30 drops' of the fluid ex¬ 
tract of ergot every 3 or 4 hours during the day is 
advisable. No drugs should be given unless pre¬ 
scribed or ordered by the attending physician, but 
do not allow your patient to suffer beyond reason; 
notify your physician at once. 

Paragraph 228 

15. WHEN CAN THE PATIENT GET UP? The patient 
should remain in bed until the uterus has become a 
pelvic organ and the lochia has ceased or is very 
light, that is, between the tenth or fourteenth day. 
When the patient first sits up, if the discharge be¬ 
comes red, it is better that she be given another 
day or two in bed. There is no necessity for a woman 
staying in bed longer than two weeks, unless there 
is some abnormal condition. As above stated, 
patients may sit up after the third day, to use the bed 
chamber or slop jar, but at no other time. She may 
leave her house and go out after she has been up a 
week or so, provided there are no bearing down pains 
and no pains in the back, and the lochia has com¬ 
pletely stopped. 

Paragraph 229 

16. POSITION OF PATIENT: The muscular tone 
of all parturient women is often deficient after 


Page Ninety-five 


LECTURES OF INTEREST TO WOMEN 


childbirth, and the condition is increased by a 
prolonged stay in bed. Therefore, it is advisable 
in all cases that an effort be made to exercise the 
different groups of muscles throughout the lying-in 
period, so if a woman moves around a great deal in 
bed and moves her arms, abdominal muscles and legs, 
and partly sits up, it is not to be discouraged, but 
rather encouraged. Pleasant fatigue is wholesome, 
but exhaustion is harmful and should be avoided. 
Therefore, do not allow your patient to exercise to 
the point of becoming over-tired. Do not allow a 
normal patient to lie on her back very long at one 
time. Have her change positions often.- If you 
should keep your patient on her back during the two 
weeks in bed she would get up with a posterior dis¬ 
placement of the uterus and the chances are never be 
well without an operation. 

Now, ladies, if you will care for your patient 
as we have instructed you, we are sure you will not 
meet with any criticisms as an obstetrical nurse. 


PAINLESS CHILDBIRTH 
Paragraph 230 

In discussing this important subject, we 
want to give the mother a clear understanding of 
what is meant by *‘Painless Childbirth,’’ and that 
it is her right as a woman to demand relief from the 
pains caused by childbirth. 

It is the duty of the physician to relieve her 
of these pains in the same spirit that he relieves 
other suffering, because if labor is purely a 
physicial process it should be as free from pain as 
other physical processes. 

Paragraph 231 

Women have been taught to believe that the 
pain during labor is a natural consequence, and 
that they must be reconciled to endure it, and the 
joy of motherhood has caused them to bear it. This is 
no reason, or proof, why women should suffer during 
labor, because the pain causes shock, and this 
shock is far more dangerous to the patient than the 
proper use of modern methods now employed to re¬ 
lieve the pain. 


Page Ninety-six 




PREPARATION OF THE PATIENT 


Paragraph 232 

So it is the duty of every physician and every 
maternity hospital to employ the safest and best 
methods to render childbirth free from pain and 
surgical shock. Physicians must learn to be more 
than midwives if they are going to give obstetrical 
cases the very best and up-to-date treatment. A 
surgeon, to qualify himself, spends years of study 
in anatomy and operative work on the cadaver, in 
order to become proficient, and yet few, if any 
surgical operations are more difficult than a 
complicated obstetrical case; and the surgical 
case requires no greater skill and no less ex¬ 
perience than does the obstetrical case, because 
two lives, in place of one, are often in the balance. 

Paragraph 233 

In recent years, the mode of living and dress 
that has been the custom of the American woman has 
rendered her physically weak to endure a long, 
tiresome and painful labor. Higher civilization 
and artifical refinement makes it necessary for 
the obstetrician, as well as the surgeon, to guard 
his patient from the dangers that accompany ex¬ 
cessive and prolonged suffering. 

The surgeon does not permit his patient to 
suffer during an operation, nor afterwards. He 
prevents surgical shock to the best of his ability. 
We get the same surgical shock during labor, which 
causes complications and delays rapid recovery. 

Now, if the surgeon takes this precaution, why not 
the physician, or institution that cares for con¬ 
finement cases, use such measures that will make 
childbirth practically free from pain and surgical 
shock. 

As a general rule, a physician allows most 
women, who are in labor for several hours, to remain 
unaided and end.ure considerable and often very 
severe pain and, as stated, women think they must 
suffer this pain; that there is no relief for them, 
so she is reconciled to endure it and suffer the 
consequences. 

Paragraph 234 

Now there is no logical reason why women 


Page Ninety-seven 


LECTURES OF INTEREST TO WOMEN 


should suffer during labor. Every maternity 
hospital should be thoroughly equipped with all 
modern appliances, and have specially trained at¬ 
tendants, in order to give obstetrical cases the 
proper care, rendering confinement a pleasure and 
safety, also insure perfect health in the future. 

Paragraph 235 

We know that the specialist on internal 
medicine, the surgeon, and the general practi¬ 
tioner send their patients to the general hospital 
—why? Because the medical treatment and surgical 
care as received in these institutions, experience 
shows, is much better than can be received at home. 
That is, the prognosis is better, and for the same 
reason, that the mother may have the care she 
rightly deserves, she should be sent to an institu¬ 
tion especially equipped for such cases. 

When she has a tumor to be removed she is sent 
to the hospital for an operation. If she has 
pneumonia, typhoid fever, or gastric ulcer, she is 
sent to the hospital—why? Because it betters her 
chances for life and health. But think of it; the 

crowning glory of her life-motherhood—there is 

little or no attention given to her. She is allowed 
to suffer in ignorance as to her confinement and 
future health. Therefore, the great mass of women 
are delivered at home, and many of them are still 
confined by ignorant, and too often filthy mid¬ 
wives. Especially is this true in the larger 
cities. On account of the -conditions existing, 
there has been no decrease in obstetrical mortality 
and future health in cases confined at home. 

Paragraph 236 

Let us quote verbatim from Dr. Davis in his 
work on ‘‘Painless Childbirth,’’ page 57. He says: 
‘‘It is a disgrace to the medical profession that 
after carefully investigating the midwife problem 
for the American Medical Association, Professor 
J. W. Williams was forced to say: ‘Ordinary prac¬ 
titioners lose proportionately as many women from 
puerperal infections as do midwives.’ And ‘More 
deaths occur each year from operations improperly 
performed by practitioners than from infection in 


Page Ninety-eight 



PREPARATION OF THE PATIENT 


the hands of midwives.’ Williams urges: ‘Education 
of the laity that poorly trained doctors are dan¬ 
gerous, that most of the ills of women result from 
poor obstetrics, and that poor women in fairly well 
conducted free hospitals usually receive better 
care than well-to-do women in their own homes; that 
the remedy lies in their own hands and that com¬ 
petent obstetricians will be forthcoming as soon 
as they are demanded. ’ It is a disgrace to the 
hospital boards that while they are providing so 
many beautiful hospitals with thousands of beds for 
the medical and surgical treatment of men, women, 
and children, they have only a few beds for mater¬ 
nity casej3. It reflects on their financial judg¬ 
ment to give so many free beds for the medical and 
surgical treatment of conditions which proper 
obstetrical care would have prevented.’’ 

Paragraph 237 

We often wonder if the mothers are going to 
continue to suffer from unnecessary ills, due to 
childbirth, in silence, and will the husbands con¬ 
tinue to bear the burdens that are associated with 
invalidism of the wife. We say: Are husbands 
going ot bear these burdens forever and make no 
effort to secure safer obstetrics? Are mothers, 
who are more or less invalids, due to poorly managed 
obstetrical cases, going to allow their daughters 
to go through the same ordeal, and allow them to 
endure the same unnecessary suffering through 
life? 

Painless childbirth is so important, yet it 
is only one of the many necessary problems that go 
to make up perfection in obstetrics. 

Paragraph 238 

The time is at hand when the mother and wife 
of today must give more time and thought to protect 
herself by demanding the best scientific care dur¬ 
ing pregnancy and confinement, and not spend so 
much time at the clubs and political activities, 
and as she becomes educated to demand this service, 
she will no longer dread the ordeal of confinement. 
She will save herself untold suffering, and will 
do the world a great good by practically eliminating 
race suicide. 


Page Ninety-nine 



LECTURES OF INTEREST TO WOMEN 


Paragraph 239 

Dr. Davis says: ‘‘Let them learn that ob¬ 
stetrical accidents will sometimes happen in the 
hands of the most skilled, but that the large per¬ 
centage of bad results are due to ignorance and lack 
of surgical cleanliness; that most of the ills fol¬ 
lowing childbirth are due to poor obstetrics and 
are unnecessary, and they will then demand the same 
skilled care in childbirth that they demand when 
they undergo a surgical operation.’’ 

The competent physician must use such methods that 
will be safe for both mother and child. 

While in recent years great progress has 
been made in preventive medicine and surgery, at 
the same time there has been no attention given to 
secure safety for the mother during her confinement. 
The high mortality that exists today, in maternity 
cases, should stimulate the reader to demand better 
and safer obstetrics. If we render childbirth 
painless and prevent surgical shock, with our 
present knowledge of asceptic surgery, there is 
not a strictly obstetrical complication, which can 
beset a woman, that cannot be successfully managed. 

Paragraph 240 

So we say, the obstetrician who has an 
accurate knowledge of obstetrics, painless child¬ 
birth and the technic of antiseptic surgery, should 
attend and manage a confinement case in the proper 
manner, and not leave his patient an invalid the 
rest of her life. As soon as the laity, both hus¬ 
band and wife, are taught to realize this fact, we 
will not have long to wait to clear away the dark 
cloud of inefficiency which hangs over us today in 
obstetrical practice. 

Paragraph 241 

Let us give, in some detail, the methods used 
in relieving the pain and surgical•shock of labor, 
and the technic of administering .them. We have at 
our command, chloroform, ether, twilight sleep 
(which is morphine and scopolamin), and nitrous 
oxid-oxygen. 

Paragraph 242 

We mention chloroform, morphine and sco- 


Page One Hundred 


PREPARATION OF THE PATIENT 


polamin simply to condemn them—the two safest 
being ether and nitrous oxide—because statistics 
show that the ratio of deaths that occur, caused by 
the administration of the above, for the relief of 
pain during confinement, one case in every 223 dies 
from the use of scopolamin and morphine; one in 
3000 from chloroform; one in 30,000 from ether, and 
one in 500,000 from nitrous - oxide . So it is not 
difficult to decide upon the choice of the proper 
preparation to administer to the maternity case in 
order to render the birth painless. 

Paragraph 243 

When childbirth is rendered painless, it 
reduces the time of confinement about 25 per cent. 
The woman does not become exhausted, therefore 
giving better uterine contractions. It costs 
from 50c to $1.00 an hour to administer the neces¬ 
sary amount of anaesthetic to produce the required 
results. 

Paragraph 244 

The husband may say, 6 ‘Why add this extra 
expense to a confinement case?” Let us argue in 
this way—Suppose'$5.00 or $10.00 is added to a 
confinement case, or even $20.00, and have the 
case properly cared for, with no pain or shock and 
free from after effects, isn’t this better than to 
have the wife suffer ill health from the results of 
a poorly managed confinement case, often requiring 
an operation, which means hospital and surgeon’s 
fee. And add to this the expense of domestic help. 
Now we ask^Where is the saving? 

Paragraph 245 

You would pay from $150.00 to $250.00 for an 
operation for appendicitis, and think nothing of 
it; therefore, why not pay a reasonable fee for the 
wife’s confinement? It requires as much surgical 
skill to confine a woman, and do it properly, as it 
does to perform an operation for appendicitis, and 
the former requires hours of a physician’s time, 
while the latter only minutes. 

There is no argument, either from a financial 
standpoint or for the patient’s safety, against 
the administration of anaesthetics that will render 
childbirth painless. 


Page One Hundred One 



LECTURES OF INTEREST TO WOMEN 


Paragraph 246 

It is not a difficult matter to have the 
necessary amount of funds on hand to meet the re¬ 
quired expense in a confinement case. There is 
nine months time for the accumulation of the required 
amount . Say the wife sets aside $10.00 a month 
from the time of conception until her confinement, 
she will have $90.00 to meet such an expense. This 
will insure her the best of care, which will guar¬ 
antee her good health in the future, and at the same 
time she will enjoy a painless childbirth. 



Page One Hundred Two 



PART II 


Contains everything re¬ 
lative to the general care 
of* the infant during the 
first year, including the 
feeding, both breast and 
artificial. 






CARE AND FEEDING OF INFANT 
DURING FIRST YEAR 



Paragraph 247 

Before we direct our attention to the first 
care of the new born infant, let us first see what 
effect labor has on the child’s organism. After 
we understand such effects, we can take care of the 
child with more intelligence. 

Paragraph 248 

The child at birth, and during the first two 
weeks, undergoes the most violent and fundamental 
changes. Many children (about three to five per 
cent) cannot survive the shock of even normal 
labors; others die in the first few weeks of life be¬ 
cause of their inability to overcome and meet the 
adverse conditions surrounding their lives. The 
effect of labor on the child’s organism is very 
severe and this explains to you why a child dies 
immediately after delivery, or in a short time 
without any apparent cause. 

Paragraph 249 

Uterine contraction during labor has more 
or less effect upon the fetal circulation. During 
the beginning of labor pains the fetal heart beats 


Page One Hundred Five 


LECTURES OF INTEREST TO WOMEN 


fast, at the extreme height of the pain it is slow, 
and as the pains cease it beats fast again. These 
changes are more marked with very strong pains, 
especially after the membranes have ruptured. As 
the head advances and when it passes through the 
pelvic floor, the fetal heart beats are usually 
very slow; sometimes it has been counted as low as 
60. We mention these facts to show you that labor 
has a marked effect upon the fetal circulation. 

Paragraph 250 

There are also changes that take place in the 
blood during labor; that is, the gradual deoxida¬ 
tion and hypercarbonization of the blood, which 
causes the respiratory centers to respond to irri¬ 
tation. The child in the uterus is in the condition 
of apnea, but when the child’s head is born and the 
placenta begins to separate, and when the baby is 
delivered with the placenta almost completely de¬ 
tached, the result is, the child passes from a 
condition of apnea to one of dyspnea, and the external 
stimulation that occurs irritates the nerve centers, 
and respiration begins. 

Paragraph 251 

When natural causes are not sufficient to 
start the infant’s breathing, it often responds 
promptly to artificial external stimulation, such 
as the sprinkling of cold water, and slapping the back 
and buttocks. This stimulation causes contraction 
of the muscles of respiration and the fetus gasps, 
and whatever lies near its mouth is sucked into the 
lungs. This is the reason why the mouth should be 
freed from all mucous immediately after the delivery 
of the head. Care should also be taken that noth¬ 
ing comes in contact with the child’s mouth in the 
way of liquor amnii, blood ,or vaginal mucous, thus 
preventing it from entering into the lungs. As 
the loss of oxygen is great and the amount of carbon 
dioxide increases at the same time, the respiratory 
centers may be paralyzed and the fetus may die with¬ 
out making any attempt to breathe. 

Paragraph 252 

This brings us to the first care of the new 
born infant. Remember how we instructed you to 


Page One Hundred Six 




CARE AND FEEDING OF INFANT 


place the baby in the basket when handed to you by the 
physician. You now realize how essential it is to 
keep the baby warm in order to reduce the shock, and 
and how important it is to give the baby special at¬ 
tention and care the first few days of life. 

Paragraph 253 

When you are ready to give the baby its special 
attention, take it from the basket into a warm 
room, or nursery, keeping it wrapped in its orig¬ 
inal blanket and lay it on a table previously cov¬ 
ered with a warm blanket. Then proceed to care for 
the baby as follows: 

Examine the baby thoroughly and see if it is 
normal in every way. Examine the cord and see that 
there is no hemorrhage and that the cord is prop¬ 
erly tied. Note the size and length of the new 
born baby—the average length should be about 20 
inches. Examine every part of the body for any 
abnormal condition. 

Paragraph 254 

CARE OF THE EYES: After you have thoroughly 
examined the baby you will next care for the eyes by 
putting in each eye (using a medicine dropper) 
one or two drops of 1% solution of nitrate of 
silver and wash it out with normal saline solution, 
using a medicine dropper, the same as for the 
silver solution. Have two medicine droppers— 
one for each solution. If there is a history 
of the mother having had gonorrhea, do not use 
the saline solution after the nitrate. The 
nitrate of silver may cause a membrane and dis¬ 
charge to form in the eye when used alone, espe¬ 
cially is this true when a 2% of nitrate is used as 
some doctors recommend. This inflammation cleans 
up in a day or two. In place of the nitrate of 
silver, some physicians use 20% solution of argyrol, 
then no saline is used. But we prefer the use of 1% 
silver nitrate and follow it with the normal 
saline solution. Normal saline solution is made 
by putting one teaspoonful of common table salt to 
a pint of water, or in that proportion. It should 
be sterilized before using. The 1% silver solution 
is obtained from any druggist. 


Page One Hundred Seven 



LECTURES OF INTEREST TO WOMEN 


Paragraph 255 

CARE OF THE SKIN: Next render the skin clean 
by using warm sterile olive oil. Apply the oil freely 
all over the body, including the scalp. Use cotton 
applicators for cleaning the nostrils and ears with 
the oil. Do not insert the applicator into the 
external opening of the ear, that is, do not allow 
any oil to enter the ear. Remove the oil and caseosa 
with a soft cloth, or cotton. Be very gentle and care¬ 
ful not to irritate the skin. If it does not clean 
easily, apply more oil, wrap up the baby in its 
blanket, replace it in its basket and let it 
remain for an hour or two when the skin can be 
properly cleaned. Caseosa is the greasy, whitish 
substance, which covers the skin of the new born 
infant. 

Paragraph 256 

After the oil has been removed, you will 
next dress the cord. Wash off the stump and adjoin¬ 
ing skin with 95% alcohol, using a cotton appli¬ 
cator, or sponge, then dry it thoroughly and keep 
it perfectly dry. Wrap a piece of gauze around the 
cord and put a gauze pad over it and apply the 
binder. A piece of flannel is best to use for a 
binder, and it should be pinned or sewed on reason¬ 
ably tight, but not So tight as to interfere with 
the child’s breathing. The binder is removed 
each day and the cord examined. Remove the gauze 
around the cord when soiled. Treat the cord as a 
surgical wound. Next put on the shirt and napkin, 
or diaper. 

Paragraph 257 

As we are instructing you about the care of 
the baby’s skin let us turn our attention to the 
normal condition of the skin of a healthy new born 
infant. At first it is red, but gradually fades as 
the baby grows older, and from the fourth to the 
seventh day, the skin often has a yellow tinge. 

This yellow color is often taken for jaundice, but 
it is only a condition of venous congestion of the 
liver, and unless the whites of the eyes are yellow, 
jaundice can be ruled out. After two or three 
weeks the skin attains a rosy pink when the baby 
is warm, and a pale blue color when the baby is 


Page One Hundred Eight 



CARE AND* FEEDING OF INFANT 


cold. The cheeks and palms of the hand are usually 
a deeper shade of red than the rest of the body. 

Paragraph 258 

After cleaning the baby’s skin as directed, 
and having it partly dressed, you will next wrap 
the baby up in a warm blanket and place it back in 
the baskets on its right side, with the foot of the 
basket still elevated about five or six inches. 
Put in the basket a hot water bottle, not too hot, 
but warm. Let the baby remain there until it is 
time to put it to the breast. Examine it often to 
see if there is any hemorrhage from the cord. An 
infant should cry occasionally and you should see 
that it does cry. 


Paragraph 259 

For the next six or eight hours divide your 
attention between the mother and the child. See 
that the mother has the needed rest, give her a hot 
drink of weak tea, malted milk, chocolate, or 
coffee, that is not too strong, and try to have 
her sleep, and as mentioned, see that the baby cries 
occasionally. It might be well at this time to 
consider the baby’s cry in general, but first let 
us discuss the application of the napkin. 

Paragraph 260 

THE NAPKIN: We will first consider the 
size and material of the napkins to be used. It 
is well to note that during the first month of life 
they should be made of cheese cloth and after that 
they should be made of the regular cotton napkin 
material. They should be oblong and folded square 
—about 36 inches long and 18 inches wide. When 
they are folded in the center you will have a napkin 
that is 18 inches square. You will then fold it 
again into a triangle. 

Paragraph 261 

As the baby grows older, you will require 20 
inch square napkins. Five dozen are usually re¬ 
quired and they should be washed each time they be¬ 
come soiled. Rinse the napkins well after wash¬ 
ing, so that all the soap or chemicals which might 


Page One Hundred Nine 



LECTURES OF INTEREST TO WOMEN 


be used in washing are thoroughly removed,. It 
saves washing and protects the tender skin to put 
a small amount of absorbent cotton inside the 
napkin. The cotton can be used the first two 
weeks. 

Paragraph 262 

To apply the napkin after it has been 
properly folded turn it down along the smooth and 
folded edge for a distance of two inches and lay 
the baby upon the napkin. Bring the opposite 
points and the front half of the lower point to¬ 
gether and hold them with one hand. Fold them 
together and bring them down between the baby’s 
leg. Now take the other half of the lower part and 
bring it up between the baby’s legs and pin them 
together. You will note that the top of the napkin 
at the back is still turned over for about two 
inches. This part that has been turned over is 
now turned up smoothly. This brings the napkin 
up higher in the back and does away with any gap. It 
is well to put on a second napkin to serve as a pro¬ 
tector. As soon as the baby’s napkin is damp it must 
be changed. 

Paragraph 263 

When the napkins are removed, they should be 
placed to soak in a covered napkin pail. This pail 
should be kept in a laundry, or any suitable place, 
and not in the nursery. 


Paragraph 264 

At this point, let me say: Never wash the 
buttocks off with warm water. Always use a damp 
soft cloth and use cold water. After the parts are 
thoroughly dried, dust on equal parts of powdered 
starch and stearate of zinc. 

Paragraph 265 

You can generally dispense with a napkin 
after the child is two years of age. We will con¬ 
sider this fully when speaking about the care of the 
baby’s bowels. 

Paragraph 266 

You may use your own pleasure in regard to 
the dressing of the baby; do it any time before the 


Page One Hundred Ten 



CARE AND FEEDING OF INFANT 


first nursing. We will now take up the baby’s cry 
in detail: 

Paragraph 267 

THE BABY’S CRY: In discussing the baby’s cry 
and all conditions relative to it, and to teach you 
how to understand its meaning, will be our aim at 
this time. You will find this to be very important, 
and we want you to become thoroughly familiar with 
this subject and we want you to remember everything 
we are going to say about the baby’s cry. 

Paragraph 268 

You will note how beneficial is the first cry 
the baby utters. It. is our duty to make it cry as 
soon as possible, in order to clear the mucous from 
its throat and windpipe, expand the baby’s lungs 
which have never breathed before, and to send the 
blood to the extremities. 

Dr. Kilmer has given a very complete outline 
on this subject, and we will quote him practically 
verbatim: When an infant is a few hours old and has 
never had its first crying spell, and you notice 
that the infant is keeping extremely quiet, examine 
it and you will find the feet and hands feel cold. 
The chances are it is not breathing regularly. When 
this condition exists, make the child cry. In order 
to cause the baby to cry, lay it on its stomach and 
put the palm of your left hand on its abdomen and 
spank it gently on its buttocks with the palm of 
your right hand. Slap it in this way from three to 
ten times and it will almost invariably begin to 
cry. After this crying spell, you will notice that 
its hands and feet get warm and its breathing be¬ 
comes much better. You will find it very difficult 
at times to teach mothers the value of making or 
letting the baby cry, but if you will explain the 
reason why this is done, and how it benefits the 
baby, they will see its necessity. 

Paragraph 269 

The conditions that will cause a baby to cry 
are as follows: 

1st-—-It is hungry. 

2nd—It is thirsty. 


Page One Hundred Eleven 



LECTURES OF INTEREST TO WOMEN 


3rd—It is in pain. 

4th—It wants attention. 

5th—It is sleepy. 

6th—Its napkins are wet. 

7th—It is tired of lying in one position. 

8th-—It is frightened. 

9th—It is exhausted. 

llth—Its clothing is uncomfortable. 

Paragraph 270 

1st. WHEN HUNGRY. The cry of hunger is a con¬ 
tinuous one, accompanied by sucking of the fingers 
or thumb, and the cry stops immediately when the 
baby gets its food. 

Paragraph 271 

2nd. WHEN THIRSTY. Usually this cry is con¬ 
tinuous, but stops when baby is given water. 

Paragraph 272 

3rd. WHEN IN PAIN. It is in pain from a pin 
prick, or any cause, when its crying is sharp and 
continuous. If from colic, the cry may be spas¬ 
modic, accompanied by drawing up of the knees and 
turning the thumbs inside the closed fingers. The 
child frequently cries on account of pain. 

Paragraph 273 

4th. WHEN THE CHILD WANTS ATTENTION. Baby 
very soon finds out that it likes attention. When 
it is laid down and you leave it and go out of its 
sight, it sets up a cry for renewed attention. It 
wants to be cuddled or rocked. If it does not get 
just what it wants it will cry. Its cry will imme¬ 
diately stop when you take it up or rock it. In 
other words, it is rapidly becoming a spoiled baby 
and the day a baby is born is the time to begin to 
train it. You can spoil the baby in a day or so, 
so that it requires a great deal of time to rectify 
your mistake. Relatives and loving mothers say, 
‘‘Oh! Don’t let him cry, take him up. He will grow 
out of it and when 1 ' he talks and understands it will 
be all right. ’ ’ If you do this and wait a few months, 
you are lost. Teach the infant that you mean what 
you say. You are the one to be obeyed, and it is for 
the child’s good that it is taught to obey. 


Page One Hundred Twelve 


CARE AND FEEDING OF INFANT 


Paragraph 274 

Now the treatment for the baby who cries 
simply because.it wants attention is what? What would 
you do? You must let it have its cry out, and the 
hardest trial for a young mother is to hear her baby 
cry and not give in, but do it she must if she is de¬ 
sirous of the best for her baby. A little self- 
denial on the part of the mother at this time may 
prevent a great deal of suffering for the child in 
after years. If it learns the lessons of self- 
restraint and self-control at this time, there will 
be no time when it will be so easy to train it as 
from the very beginning. If you let the baby alone 
and it finds that no matter how hard it cries no one 
seems to care, it will stop crying. Often, one good 
cry is all that is necessary. If a baby is not born 
with a rupture and it wears a good supporting ab¬ 
dominal band, there is absolutely no danger. 

Paragraph 275 

5th. WHEN SLEEPY. Babies will often fight 
against going to sleep. They will cry loudly at first, 
but finally the cries become weaker, and with a 
little moan or sigh baby is asleep. When it is time 
for baby to sleep put it in its basket and see that it 
goes to sleep. Do not take it up because it cries. 

Paragraph 276 

6th. WHEN THE NAPKINS ARE WET. When baby 
cries, always examine the napkins and change them 
if they are damp or soiled. 

Paragraph 277 

7th. BABY GETS TIRED OF LYING IN ONE POSITION. 
Very young babies, and also weak babies, are unable 
to change their position themselves. In such cases, 
if you will change their position and lay them on 
the other side, it will often stop their crying. 
This is also true of any baby that seems to be rest¬ 
less without any apparent cause. 

Paragraph 278 

8th. WHEN FRIGHTENED. Babies from six months 
to two years old will often become frightened to 
find themselves in a dark room, or after a bad 
dream, and they will cry out in a shrieking voice. 


Page One Hundred Thirteen 




LECTURES OF INTEREST TO WOMEN 


They should be taken up in a soothing way and, as 
soon as the crying is over, they should be placed 
back in bed again. This is generally sufficient to 
quiet them. They may also do this when they come 
in contact with strangers. 

Paragraph 279 

9th. WHEN EXHAUSTED. A cry from this cause 
will be usually a low, moaning cry and occurs in very 
ill or weak babies. 

Paragraph 280 

10th. WHEN CRYING FROM TEMPER. This form of 
temper is seen in older children. They cry loudly, 
swing their arms and kick their feet. Tears are 
supposed to be seen in babies crying from pain, but 
if you will notice you will often see real tears from 
nothing but temper. Tears do not usually show them¬ 
selves until after the baby is from one and one-half 
to three months old. 

Paragraph 281 

11th. UNCOMFORTABLE CLOTHING. Often baby’s 
bands, or napkins, become uncomfortable and hurt 
it. Take it up and straighten out its clothing, and 
it will often stop crying if this is the cause. 

Young infants cry quite frequently, and it 
is healthful to let them cry. It is a part of their 
daily exercise and is beneficial to their general 
development. When you have a baby who cries a great 
deal, go over the list given here and enumerate 
every one, and if it is not crying from any cause ex¬ 
cept it 4 ‘Wants Attention, ’ ’ let it have its cry out. 

Paragraph 282 

DRESSING THE BABY: Now we will direct our 
attention to finish the dressing of the infant. 

Use such clothing as the mother has prepared. It has 
its band and napkins on; now put on its shirt, a 
Gertrude petticoat, which is best, a flannel night 
gown, etc. It is best to use a pinning blanket for 
the first six weeks. It keeps the body and feet 
warm. Keep a small blanket around the baby at all 
times. 

Paragraph 283 

Dress the infant before you take it into the 
mother to nurse (which is 6 to 8 hours after the 
birth) if the mother’s condition is normal. 


Page One Hundred Fourteen 



CARE AND FEEDING OF INFANT 


Paragraph 284 

Before putting the baby to the breast * wash 
out the infant’s mouth again with absorbent cotton, 
wet with saturated solution of boracic acid. The 
absorbent cotton is wound around the little finger¬ 
tip, after being well saturated with the solution, 
the finger is then inserted in the baby’s mouth and 
the whole inside of the cavity is gently wiped out. 
The baby’s mouth should be thoroughly cleansed in 
this manner at least once a day. Some contend that 
this should be done before and after each nursing, 
either from the breast or bottle, but if the nipples 
and breast are kept perfectly sterile, as directed, 
and the bottle and nipples are thoroughly steri¬ 
lized, we question if it is necessary to irritate 
the mucous membrane of the mouth, as it naturally 
would be from so frequent washing. If you wash 
the baby’s mouth out once a day, and do it well, that 
will be sufficient. 


Paragraph 285 

There is a general daily routine and care to 
give the infant, together with proper watching and 
management. You must learn how to properly give the 
baby its bath and care for the eyes, mouth and cord. 
See that it gets the required amount of sleep, and 
take a record of the rectal temperature daily. See 
that the baby gets the proper amount of food, in 
regard to time and amount, whether it is breast or 
artificial feeding. Weigh the baby daily in order 
to ascertain the gain it is making. See that the 
bowels and kidneys are acting properly. See that it 
has plenty of fresh air, that it is properly clothed 
and that it is properly covered, but not too much, 
as it will perspire when asleep. 

Paragraph 286 

CARE OF THE CORD: You have been instructed 
how to dress the cord the first time, and the dress¬ 
ings should be changed when they become soiled. The 
cord generally separates and drops off within two 
weeks, either by dry or moist gangrene; the former 
is preferable, and for that reason we try and keep 
it dry. If the dressing is dislodged, or becomes 
wet, it should be soaked off with a bichloride solu- 


Page One Hundred Fifteen 


LECTURES OF INTEREST TO WOMEN 


tion 1-2000, and the stump should be washed with 
95% alcohol and a new gauze dressing applied. We 
do not use dusting powders unless there are signs of 
moist gangrene, then a powder of 1 part of salicylic 
acid to 20 parts of starch (sterilized) is applied 
after thoroughly cleansing the parts with alcohol. 
Generally moist gangrene, or any infection that may 
develop around the stump, can be cured by applying 
a wet dressing of 50% alcohol for six or eight hours. 
Remember that during all these dressings you must 
have your hands properly sterilized if they come in 
contact with the cord. If the hands are not steril¬ 
ized, you must use sterile cotton applicators. 

After the cord comes off, if the stump does not heal 
readily, and there is a discharge (often slightly 
bloody), take an applicator and clean out the navel 
thoroughly with 95% alcohol and then dust on 
stearate of zinc and it will soon heal. 

Paragraph 287 

CARE OF THE EYES: In normal cases it is not 
necessary to put any medicine in the eyes after the 
first treatment. When giving the bath, wash the 
eyelids off with saturated solution of boracic 
acid; also clean the mouth thoroughly at the same 
time, as directed. 

Paragraph 288 

CARE OF THE NOSE AND EARS: Apply olive oil 
daily for the first two or three months with sterile 
cotton applicators, and wipe out the nostrils, also 
the folds around and about the ears, remembering 
not to let any oil get inside the ears. 

Paragraph 289 

CARE OF THE NAILS. It is necessary to keep 
the finger and toe nails in proper condition, 

Trim the finger nails with a manicure scissors level 
with the finger tips, and at the same time remove 
all the hang nails, which should be cut off close 
to the skin. Keep the finger nails clean with a 
soft nail brush. 

Toe nails should be trimmed straight across 
with a pair of straight scissors. Do not round the 
corners, but let the edge of the nail grow out over 
the toe, and this will prevent ingrowing toe nails. 


Page One Hundred Sixteen 


CARE AND FEEDING OF INFANT 


Paragraph 290 

CARE OF THE SCALP. The head should be washed 
daily during the first six months with warm water 
and pure Castile soap. A soft wash-cloth should 
be used. After the infant is six months old, con¬ 
tinue the daily washing with warm water but do not 
use so much soap. After the baby is two years old 
soap should be used only once a week. Care should 
be taken not to use too much friction and irritation 
in washing the scalp, as there is danger of injuring 
the skin. All the soap must be removed. This is 
done with a very fine soft sponge dipped in warm 
water. Both the sponge and wash-cloth must be 
well washed out and thoroughly dried in the air 
before using them for the next treatment. The 
sponge and wash-cloth used for cleansing the scalp 
should not be used for any other purpose. To pre¬ 
vent the accumulation of dandruff, or little scales 
that so often form on the scalp, you will occasion¬ 
ally apply a little white vaseline or olive oil 
well rubbed into the scalp. 

Paragraph 291 

PRICKLY HEAT. Oftentimes, especially in hot 
weather, babies have a little fine red rash which 
is very irritating, and makes them quite fretful. 
The bran bath is very beneficial for this condi¬ 
tion, and it is made by putting one pint of bran 
into a muslin bag and immersed in warm water until 
thoroughly soaked; then the bran bag is well 
squeezed out in the bath water until it becomes 
quite milky. The temperature should be that of the 
warm bath. Keep the baby in it from two to six 
minutes. No friction of the skin is necessary, and 
after the bath the baby is dried with a soft towel. 

Paragraph 292 

AN INFANT’S WEIGHT: The baby’s weight is an 
important factor in connection with the care of the 
infant, and great attention should be given to it, 
instead of being neglected as it so often is, espe¬ 
cially from birth and during the first year. To 
estimate the progress the infant is making, gain in 
weight is valuable, but we must not, of course, 
rely wholly upon the development of the child as 


Page One Hundred Seventeen 



LECTURES OF INTEREST TO WOMEN 


regards weight; and because a baby is not gaining 
weight according to fixed rules, is no evidence 
that the quantity of food should be increased, as 
statistics show that such an error will cause more 
deaths than bacteria and hot weather combined. 

Paragraph 293 

At birth the average normal infant should 
weigh from 6 to 8 pounds. A baby girl 6 to 7 pounds; 
a boy 7 to 8 pounds. There is generally an initial 
loss of weight that occurs the first few days. Gen¬ 
erally the lowest mark is reached on the third to 
the fifth day, after which time the baby begins to 
gain and normally reaches the original weight on 
the tenth to the fifteenth day. The total loss is 
from six to eight ounces, but the variation may be 
from two ounces to one pound. When there is a 
greater loss in weight than one pound, especially 
in a small infant, it should be regarded as patho¬ 
logical and the condition should be carefully in¬ 
vestigated and reported to the physicion in order 
that he may determine the cause. A fat baby is more 
likely to lose weight than a thin one. 

Paragraph 294 

Great losses in thin babies are more likely 
to indicate some pathological condition. Just why 
babies lose, we cannot say positively. Perhaps the 
child does not receive sufficient food for the first 
few days of life, which may have something to do with 
this condition. Another possible conclusion is the 
one advanced by Rott—it is a loss of water, and is 
probably due to the fact that these babies received 
very little fluid in any form. We believe babies 
lose less and receive less shock when care is 
taken not to tie the cord until pulsation ceases. 

By doing this infants receive from the mother one 
to two ounces of blood. This extra blood the child 
needs in its first few days of life. 

Paragraph 295 

Babies increase in weight more rapidly in the 
first half than in the second half of the first year. 
The gain the first six months should be from six to 
eight ounces a week. From the sixth to the twelfth 
month, the gain should not be more than from two to 


Page One Hundred Eighteen 




CARE AND FEEDING OF INFANT 


three ounces a week, so the first year the gain is 
about a pound a month, or twelve pounds gain since 
birth. These weights refer to normal breast-fed 
infants. 

Paragraph 296 

The question of normal weight from birth with 
artificial feeding is an open one. To feed a child 
from birth artificially and have it gain steadily, 
and keep it free from gastro-intestinal disturb¬ 
ances, is much more uncommon than we naturally sup¬ 
pose. In artificial feeding, we do not pay so much 
attention to the increase in weight as we do to keep¬ 
ing the gastro-intestinal tract in a healthy and 
normal condition. 


Paragraph 297 

If we have a steady gain of four ounces a 
week during the whole of the first year, that is the 
best we can hope to secure in an artificially fed 
infant, and this only when all other conditions are 
normal. If a gain should be as high as eight ounces 
a week, which is an excessive gain, we must expect it 
to be followed by a catastrophe of some kind. In 
other words, look for trouble ahead. 


Paragraph 298 

So you see how important is the correct and 
careful record of baby’s weight from the time of 
birth to the end of the first year. Many mothers 
and nurses neglect to keep this record. A knowledge 
of the correct weight of a baby—whether it is losing 
or gaining—is one of the most essential features 
in the care of an infant. Many mothers when asked 
whether baby is losing or gaining weight will reply: 
“I do not know, he feels lighter (or heavier) than 
he did a week ago. ’ ’ Now, we do not want to know 
whether an infant FEELS lighter or heavier, but what 
we want to know is the exact weight of the baby. 

A correct daily record is absolutely necessary. 

An infant should be weighed every day (at the same 
time each day) for the first three months of life. 
Then if conditions are normal, it should be weighed 
weekly, say every Monday, for the next three months, 
and then every two weeks until one year old. 


Page One Hundred Nineteen 



LECTURES OF INTEREST TO WOMEN 


Paragraph 299 

A regular gain is an ideal one. If a baby is 
fed entirely upon starchy, or some of the prepared 
foods, a great and sudden gain in weight will be the 
result, but that child will not be as strong physic¬ 
ally as the baby who has had a milk diet (either 
breast or artificial) with a slow but steady gain in 
weight. It is a good plan to provide yourself with 
a weight-chart, upon which a proper record of baby’s 
weight can be kept. A good chart for this purpose 
is the one devised by Dr. Walter Lester Carr. Our 
Hospital record is-of the same plan. In fact, it is 
the same idea copied and arranged to meet our re¬ 
quirements . 

Paragraph 300 

TABLE OF AVERAGE WEIGHT DURING THE 
FIRST YEAR OF LIFE. 


Month Average Weight 

1 ...7 to 8% 

2 ..... 10 % 

3 ...... 12% 

4 . 13% 

5 . 14% 

6 ..... 15% 

7 ... 16% 

8 .... 17 

9 ... 17% 

10 . 18 

11 . 18% 

12 ... 20 


It will be seen by this table that the infant’s 
most rapid gain in weight is during the first three 
months of life. During the second year a child gains 
about five pounds. 

Paragraph 301 

WEIGHING THE BABY: The scales must be accur¬ 
ate. The family scales with a scoop may be used up 
to twenty-four pounds. A more expensive and deli¬ 
cate scale is the kind we have in the nursery. It is 
of special design, a very convenient and accurate 
basket scale for weighing infants. There are many 
good scales of this nature on the market. 

When ready to weigh the baby, take a light 


Page One Hundred Twenty 
















CARE AND FEEDING OF INFANT 


soft blanket, place it in the scale-pan, or basket, 
and adjust the scales so that they balance with the 
blanket in the basket. Now undress the baby, take 
everything off, including the napkin. After remov¬ 
ing all clothing, wrap the baby up in the blanket 
referred to, and weigh it. The weight registered 
is the exact weight of the baby. Always balance the 
scales each time with the blanket in the scales bas¬ 
ket before weighing the baby, and always weigh the 
baby as directed. A baby is usually weighed just 
before the bath. 

Paragraph 302 

ACTION OF THE KIDNEYS: You will note from 
birth as to the frequency and amount of urine 
passed, and report it to the attending physician. 
Do not let a napkin dry and think the baby has not 
urinated, but if the baby does not urinate during 
the first 24 hours there is no reason to be alarmed, 
as long as there is no tumor formed in the region of 
the bladder above the pubes. If you are sure that 
the baby has not urinated, you will assist it by 
washing the orifice of the urethra with boracic acid 
solution, removing any smegma that may be present. 
Give the baby a teaspoonful of cold water and put it 
in a hot bath. Put your hand over the orifice of the 
urethra and you will feel the stream of urine, if 
any is passed. You can also put hot flannels over 
the bladder and carefully watch the napkins for the 
next few hours. Remember, there is no cause for 
anxiety if there is not a full bladder forming a 
tumor above the pubes, providing the infant does 
not urinate. 

Paragraph 303 

If you cannot get the baby to urinate within 
36 hours after birth, notify the attending physi¬ 
cian, as it may be necessary that the baby be 
catheterized or examined to see if there is any ab¬ 
normal condition present. 

Paragraph 304 

BATHING THE BABY: During the time the cord 
is coming off, we use but very little water on the 
baby’s skin, giving only a sponge bath. The baby’s 
hands, feet, face, neck and ears are gently washed, 


Page One Hundred Twenty-One 



LECTURES OF INTEREST TO WOMEN 


using pure Castile soap and water, without apply¬ 
ing too much friction. The rest of the body is 
gently sponged off, following with a warm olive oil 
rub. After the cord falls off, the baby should have 
its daily morning tub bath. 

Paragraph 305 

The bath should be given about an hour after 
the 9 o’clock feeding. Rubber bath tubs are to be 
recommended because the baby can splash and play as 
much as it desires without any danger of injuring 
itself by falling and striking the sides of the tub. 
Any metal bath tub of suitable size can be used, but 
it will require more care on your part. 

Paragraph 306 

The temperature of the water should be from 
98 to 100 degrees Fahrenheit for a young infant. 

By the time the baby is a year old, the tem¬ 
perature should be as low as 90 degrees Fahrenheit. 
Always use a bath thermometer to test the tempera¬ 
ture of the water. The temperature of the room in 
which the baby is bathed should be 70 degrees, at 
least. 

Paragraph 307 

Hold the baby entirely with your left hand 
while it is in the tub, and use the right hand for 
washing it. The child should remain in the tub for 
about three or four minutes. Lift the baby out of 
the tub by placing one hand under its buttocks and 
the other hand supporting its back and head, and 
lay it on its back on your lap, or on a table, with a 
soft warm towel under it. Have a flannel blanket 
under the towel. Roll it from side to side and pat 
it gently all over—do not rub. After the ex¬ 
cess of water has been dried by the towel, pull the 
damp towel out and let it rest on the flannel blan¬ 
ket. Roll it up in this blanket and pat it once 
more until dry. Rub it thoroughly with your warm, 
dry, bare hand for half a minute or so. Sprinkle 
sterile talcum powder on the buttocks, in the 
creases in the thighs, and under the arms. You 
should put the binder on young infants, and this is 
generally worn until the baby is six to eight weeks 


Page One Hundred Twenty-two 




CARE AND FEEDING OF INFANT 


old. Finally put on the napkin and then its 
clothes. Well-kept babies need little, if any, 
dusting powder, but if the parts do become chafed, 
use sterile stearate of zinc. 

Paragraph 308 

PULSE RATE: The pulse in a new-born is about 
120 per minute, and remains well above 100 in the 
first year of life. The pulse rate should be taken 
only when the infant is quiet. 

Paragraph 309 

RESPIRATION: The respirations in an infant 

are from 25 to 30 per minute. Respirations should 
also be taken when the baby is quiet. 

Paragraph 310 

TEMPERATURE: It is very important to recog¬ 

nize that there is a distinct normal temperature 
variation for the infant, and that any variation 
above and below this means an abnormal condition. 
Temperature in the infant should be taken per rec¬ 
tum, and should register 98 6/10, the same as the 
normal temperature of the adult. Variations from 
the normal temperature in the infant should not be 
more than from 98 2/10 to 99. You will take the 
temperature each day while giving the baby its gen¬ 
eral morning care, for the first two weeks, after 
that it is not necessary unless some abnormal con¬ 
ditions develop. 


Paragraph 311 

SLEEP. The healthy new-born infant usually 
sleeps most of the twenty-four hours, and the sleep 
is sound. During the third and fourth week, the 
sleep is less profound—the infant being more read¬ 
ily aroused—and the total number of sleeping hours 
is about twenty. As the infant grows older, it 
sleeps less and less, and at six months, the time 
spent in sleep is about sixteen hours, consisting 
of a twelve-hour night rest from 6 P.M. to 6 A.M., 
interrupted only by the late evening feeding, and 
of a two-hour morning nap and a two-hour afternoon 
nap. The twelve-hour night rest should be con¬ 
tinued until the child is six years old, the day 

Page One Hundred Twenty-three 


LECTURES OF INTEREST TO WOMEN 


naps being, of course, shortened. At the age of one 
year, a two-hour nap in the morning, and a one-hour 
nap in the afternoon is sufficient; while from the 
eighteenth month to the end of the second year, the 
morning nap may be omitted. An afternoon nap of 
one and a half to two hours should be continued until 
the child is six years old. The child must always 
be allowed to awaken of its own accord in the morn¬ 
ing after its night’s sleep. 

Paragraph 312 

For the first two or three weeks after birth, 
the new-born infant should not sleep in the same 
room with its mother. Its cry will disturb her 
rest, which is so essential for the rapid recovery 
of her strength and nervous system. 

Paragraph 313 

BABY’S BED. The most practical bed is a 
large basket on rollers; with it baby is moved from 
one room to another without disturbing it—such a 
basket should have no top or canopy. Put a hair mat¬ 
tress or pillow in the bottom of the basket; over 
this place a quilted pad covered with a cotton 
sheet. It is convenient to have a second quilted 
pad placed over the cotton sheet, and place the baby 
on this last pad. If it becomes wet or soiled, it is 
removed and the remainder of the bed is kept dry. 

The mattress or pillow is so arranged that the baby’s 
head is slightly higher than its feet. Some in¬ 
fants require a small head pillow; others sleep 
better without it. Baby’s bed should be provided 
with two thin and two thick flannel blankets. Do 
not cover a baby when asleep, just use enough bed¬ 
ding to keep it warm—a baby should not perspire 
while sleeping. Over the mattress spread a small 
rubber sheet, and have it large enough to protect 
the mattress, which comes directly under the baby’s 
buttocks. 

Paragraph 314 

When the baby has grown out of its basket bed, 
it should sleep in its crib. The white enameled 
iron crib with sides that may be lowered at will, is 
the most satisfactory. Babies can sleep in these 
cribs for three or four years. The crib should have 


Page One-Hundred Twenty-four 



CARE AND FEEDING OF INFANT 


high sides to prevent the baby from falling over the 
railing when it stands up. The crib should be placed 
beside the mother’s bed. When the baby is a year 
and a half old, the crib can be placed in the nursery, 
and the baby left alone, especially at night, as the 
baby retires early and will not be disturbed by any 
other members of the family. 

Paragraph 315 

Regularity and Training.—It is important, 
from the very first, to train a baby to sleep at reg¬ 
ular definite hours; otherwise the mother’s life 
will become a burden to her. During infancy, the 
baby should be awakened punctually at the feeding 
hours in the day time, and thus be trained to sleep 
between feedings. It is unnecessary every time to 
lift the baby from its bed at night except to nurse 
it. The diaper can be changed, the feeding bottle 
given, and other needed attentions accomplished 
without lifting the baby. To walk the floor at 
night, or to be obliged to sit in the room, or to 
sing a baby to sleep is an uncalled for martyrdom. 
Unless the baby is sick, it should be put in bed at 
night and trained to stay there until morning. 

Never rock a well baby to sleep. Let it be taught 
from birth that when it is placed in its crib or bed, 
it is to go to sleep. 


Paragraph 316 

Disturbed Sleep.—With infants and children, 
undue excitement or romping games should not .be 
indulged in for at least one hour before bedtime, 
because this is just the time above all others, when 
their little nervous system should be at rest; 
otherwise the child will sleep badly. Tossing in 
the sleep without awaking is due either to unsuit¬ 
able food, indigestion, poor nutrition, previous 
excitement or serious illness. 

Paragraph 317 

Sleeping with Mouth Open.—This indicates 
some obstruction to the breathing, and is often 
due to abnormal growths called ‘‘adenoids,’’ 
situated in the back of the nose at the junction with 
the throat. When a baby sleeps with open mouth, 


Page One Hundred Twenty-five 




LECTURES OF INTEREST TO WOMEN 


a physician should always be consulted, since the 
obstruction to the breathing lowers the vitality, 
predisposes to cold in the head, and may even lead 
to deafness. 


Paragraph 318 

Sleeping with the Mother.—An infant should* 
never sleep in the same bed with its mother; even 
in the poorest families; the infant should have its 
own bed. Not only is there a possible danger of 
the mother rolling over on her baby and suffocating 
it—a danger which is real and not imaginary—but 
there is the temptation on the part of the mother to 
nurse her baby too often; moreover, the baby is 
liable to get the bed clothes over its head and be¬ 
come smothered, and in any event the health of the 
baby is unfavorably influenced, as it does not get 
enough air when sleeping with another person. It 
should always sleep alone. 

Paragraph 319 

Sleeping Outdoors.—Unless the weather is 
stormy, the baby, after it is two or three weeks old, 
will derive much benefit and health from sleeping 
outdoors in the day time between 7 A. M. and 7 P. M. 
in the summer, and between 9 A. M. and 4 P. M. in 
winter. In the summer the baby may be placed in a 
baby carriage and kept in a shaded spot; in the win¬ 
ter—except when the weather is freezing—the baby 
may be well wrapped up, and placed in its carriage 
on a side porch. 


Paragraph 320 

The best time to air an infant is: In the 
Spring from 9 A. M. to 4 P. M. 

Summer from 7 A. M. to 6 P. M. 

Fall from 9 A. M. to 4 P. M. 

Winter from 9 A. M. to 3 P. M. 

If you want to air the baby indoors after it 
is one month old, you will clothe it the same as for 
outdoors, put it in its carriage, open the windows, 
and allow it to be aired in this way for half an 
hour. On rainy and stormy days baby must have its 
airing indoors. When the days are very hot, keep 
the baby in the house between 11 and 2 each day. 


Page One Hundred Twenty-six 


CARE AND FEEDING OF INFANT 


Paragraph 321 

FEEDING THE BABY: Now, to feed the infant in 
an intelligent way, it is necessary for you to know 
a few facts regarding the child. In the first place 
you should have some knowledge of the anatomy and 
physiology of the stomach found in childhood. You 
should also know something about food absorption, 
as well as the characteristics of the normal child. 

Paragraph 322 

The average new-born baby’s stomach holds, 
without distention, only about one to one and one- 
half ounces, or even less. If distended, in some 
cases it may hold two ounces. Now, one of the most 
frequent mistakes made in feeding the baby is to 
give it a greater quantity of food than can possibly 
be assimilated, and the result of this error is 
that it either vomits it or it passes through the 
bowels in an undigested condition. 

Paragraph 323 

The stomach at birth is nearly a horseshoe in 
shape, with the convexity toward the left side, the 
whole completely covered anteriorally by the liver. 

When the child is in an erect attitude the 
position of the stomach is changed, owing to the re¬ 
spiratory movements of the diaphragm. This ex¬ 
plains why gas is expelled from the stomach when 
baby is held on your chest or shoulders and any 
slight friction applied to the child’s back. 

Paragraph 324 

As the child develops, the capacity of the 
stomach is a matter of much importance. While it 
cannot be determined with absolute accuracy, Holt 
states that at three months it holds about 4% 
ounces, at six months, 6 ounces, and at one year, 9 
ounces. 

Paragraph 325 

The poor peristaltic action, and the small 
amount of elastic tissue present in the muscular 
walls of the intestines in the infant, is possibly 
the cause of so much constipation; the constipation 
accompanied with the accumulation of gas and dis¬ 
tension, a condition we find so often in the infant. 


Page One Hundred Twenty-seven 



LECTURES OF INTEREST TO WOMEN 


The liver is relatively much larger in the infant 
than in the adult, and this may account for the fact 
that changing the position of the child often re 1 
lieves the pressure on the stomach, and the child 
will become quiet when turned and placed on its 
right side. There is a condition that occurs in the 
liver of the infant known as venous stasis, which 
is probably due to the distended and tortuous condi¬ 
tion of the bile capillaries which exists in the 
new born child, and this condition often accounts 
for the yellow condition of the skin which sometimes 
occurs in infancy, and is known as icterus neona¬ 
torum. It clears up in a few days and needs no treat¬ 
ment. Caster Oil which is generally given will 
do no good. Unless the whites of the eyes are yellow 
it is not a case of jaundice. 


Paragraph 326 

The physiology of the stomach should be of 
interest on account of its important relation to 
vomiting and to the length of the intervals between 
feeding. The motor activity of the stomach has 
been demonstrated that when we have a fluid in the 
stomach that is acid in reaction, it will cause the 
pylorus of the stomach to open, allowing its con¬ 
tents to pass into the small intestine, which 
is immediately attached to the stomach. It causes 
the stomach to remain closed. We think it was Canon 
who demonstrated this fact. Let us see what hap¬ 
pens when milk is taken into the baby’s stomach. 
First, it coagulates. After that, we have whey and 
curds in the stomach. The whey is acid and passes 
the pylorus first, together with any added sugars 
that may be present. The proteids require a longer 
time, because free acid must be present. Fatty 
acids and neutral fats are the last to pass, pos¬ 
sibly not because they do not become acid, but be¬ 
cause the fatty acids require a longer time to 
be neutralized by the intestinal juice, and hence 
the stomach remains closed on account of this acid 
condition; so you see that when we have a high 
fatty condition of the food there is delay in the 
passage of the stomach contents through the pylorus. 


Page One Hundred Twenty-eight 






CARE AND FEEDING OF INFANT 


Paragraph 327 

The stomach is emptied much more quickly in 
the breast fed baby—the average being about two 
hours. Time varies with the amount taken. As to 
modified cow’s milk, the same allowance must be 
made, but in the majority of cases the food leaves 
the stomach after about three hours. However, in¬ 
dividual cases may vary greatly from the general 
rule. 

Paragraph 328 

Carlson found that hunger waves appear in the 
stomach of the infant 2K to 3 hours after the diges¬ 
tion of food. He states that they probably indi¬ 
cate that the stomach is ready to receive food, yet 
hunger waves do not always indicate the pressure 
of an empty stomach. 

Paragraph 329 

The acidity of the gastric juices is due to 
several substances: that is, hydrochloric acid, 
lactric acid, fatty acids, and phosphoric acids, 
also the acid substances in human milk. Now free 
hydrochloric acids increases as digestion ad¬ 
vances; therefore the longer intervals between 
feeding the more hydrochloric acid is present, 
which gives the gastric juices great power to de¬ 
stroy bacteria. Thus, fi om the action of hydro¬ 
chloric acid, and other digestive substances, the 
casein in cow’s milk is prevented from producing 
specific poisons in the infant organism. 

Paragraph 330 

The pancreas of the new born infant contains 
all of the ferments found in the adult, only in 
much smaller quantities. The liver in the new born 
performs the same functions as it does in the 
adult. We must also remember that in the infant, 
the digestive organs must not only make good the 
body waste, but also supply tissue for the forma¬ 
tion of the growth of the body, and at the times when 
the body growth is relatively much greater than 
at any subsequent period of life, we may readily 
account to a great extent for the frequent gastro¬ 
intestinal disturbances in the first and second 
years of life. 


Page One Hundred Twenty-nine 


LECTURES OF INTEREST TO WOMEN 


Paragraph 331 

The absorption of food stuffs by the infant 
has proven that the protein of cow’s milk is as well 
taken care of as that of the human milk. The same 
can be said of the fats, and no material of the body 
is so valuable as the body fats. In the body of 
the new born the proportion of fat is greater than 
in the adult. It must be remembered that from 87 to 
98% of the fat taken into the system is absorbed. 
The same can be said of the carbohydrates. Milk 
sugar probably requires a longer time to be absorb¬ 
ed than malt sugar, while cane sugar seems to be dis¬ 
tinctly irritating to the intestines of the young 
infant. In severe nutritional disturbances some 
of the forms of sugar are generally found in the 
urine. When sugar is given in excess, it seems to 
favor a retention of water in the system, which is 
loosely combined, and is probably held in the sub¬ 
cutaneous tissue; and we find that children who 
have been overfed with sugar, especially in the 
form of some of the condensed milks, lose so rapid¬ 
ly when taken with any intestinal trouble, as to 
jeopardize their lives. This is explained by the 
loss of large quantities of water (in the form of a 
solution of salt, which is very loosely held in the 
tissues). Another important action of the sugar 
is the production of fever that generally occurs in 
elementary intoxication. Of recent years, there 
is being devoted a great deal of study to the various 
salts that are contained in food. Sodium and Potas¬ 
sium have been given the greatest attention and it 
is found that sodium promotes water retention, pro¬ 
duces a rise in temperature, and increases the nerv¬ 
ous irritability; while potassium produces only a 
temporary water retention, and rarely causes a rise 
in temperature. Animal foods are rich in Sodium; 
vegetable foods are rich in potassium. Of mag¬ 
nesium, little is known. Phosphorus in the organ¬ 
ism is of great importance, first, because of its en¬ 
trance into proteid muclei, and second, because of 
the phosphorus present in bone. 

Paragraph 332 

In regard to water retention, it has been 
discovered that there are three classes of cases; 


Page One Hundred Thirty 




CARE AND FEEDING OF INFANT 


first, those in which there was a decrease in weight 
when the food was concentrated and the weight in¬ 
creased only after the addition of water. Second: 
those where the weight remained the same on a con¬ 
centrated food, and there was an increase after the 
addition of water. Third: those in which the addi¬ 
tion of water made no difference, but which did well 
on a concentrated food. 

Paragraph 333 

The feeding of the baby is a matter of great 
importance and often the most difficult of all 
questions that confronts the physician, nurse and 
mother who has the care and feeding of the child. 
Infant feeding is divided into two classes: 

1. Breast-feeding. 

2. Bottle-feeding. 

Paragraph 334 

Fortunate is the child that belongs to the 
first class, because human milk gives the proper 
and ideal food for infants. No artificial food (no 
matter how careful its preparation) is equal to 
mother’s milk, and statistics show that breast-fed 
babies, as a class, are larger and healthier than 
the bottle-fed ones, and that the mortality among 
them is far less, so from the standpoint of im¬ 
portance we will first consider breast-feeding. 

Paragraph 335 

There is some difference of opinion regard¬ 
ing the time when the baby should be first put to the 
breast. To settle this question, we will treat the 
child like any other little new-born animal. The 
natural instinct of a baby is to suck—so let the 
infant nurse as sooh as the mother has fully recov¬ 
ered from her confinement and feels rested. This 
generally requires from six to eight hours, in 
some cases twelve hours. After that put the baby 
to the breast every six hours until the secretion of 
milk becomes well established, which is about the 
third day. 

Paragraph 336 

This early nursing has four good effects: 

1. It assures good uterine contraction. 


Page One Hundred Thirty-one 




LECTURES OF INTEREST TO WOMEN 


2. The fluid . (colostrum) that is secreted 
in the breast during the first three days acts as a 
cathartic upon the infant’s bowels—it is human 
Castor Oil. 

3. It stimulates the secretion of milk. 

4. It draws out the nipple and puts it in bet¬ 
ter shape for future nursing. It is easier to ac¬ 
complish this, and properly develop the nipple, 
while the breast is still flaccid, than it is after 
it has become full and tense with the contained milk. 


Paragraph 337 

As a rule, no feeding is necessary the first 
three days except what the baby obtains from the 
breasts, yet if the infant really seems to be raven¬ 
ously hungry, as shown by the manner in which it 
grabs the nipple and persistently cries, give an 
ounce of moderately hot water (which has previously 
been boiled) two or three times in 24 hours. This 
will generally satisfy the child. The water may be 
sweetened by adding one teaspoonful of sugar of 
milk (Mercks) to eight ounces of water. If the in¬ 
fant will take the plain water, omit the sugar. 
Saccharine may be used; dissolve one tablet in 8 
teaspoonfuls of water. Put one teaspoonful of this 
solution in one ounce of water. All other foods are 
unnecessary and often harmful. 


Paragraph 338 

After the milk becomes well established, 
which is about the third day, as mentioned above, 
the child should nurse regularly every three hours 
during the day. The hours for fe'eding are as fol¬ 
lows : 

6 A. M. , 9 A. M. , 12 M. , 3 P. M., 6 P. M. , 10 P. 
M. , 2 A. M. The two o’clock night feeding is omit¬ 
ted after the second week. You will notice the 
night feedings are four hours apart. This gives 
the baby’s stomach more rest and does not disturb 
the mother’s rest and sleep so often, as well as the 
child’s—and this is true especially when the two 
o’clock morning feeding is omitted. 


Page One Hundred Thirty-two 


CARE AND FEEDING OF INFANT 


Paragraph 339 

If the baby is asleep when the hour for nurs¬ 
ing comes, it should be awakened and fed. It is ab¬ 
solutely imperative to have the infant nurse regu¬ 
larly, as stated in the above schedule. Usually 
the child soon learns to waken of its own accord at 
the proper time. Regularity is the one important 
principle in infant feeding. Do not allow the baby 
to go to sleep at the breast with the nipple in its 
mouth; keep it awake while nursing. The time a baby 
should nurse at each feeding is from fifteen to 
twenty minutes. Do not allow the habit to be form¬ 
ed of nursing the child every time it cries, simply 
for the sake of quieting it. 

Paragraph 340 

At the end of the second or third week, when 
the two o’clock feeding at night is omitted, and if 
baby wakes up and cries at this time, give it an 
ounce of warm water. Remember all babies should 
be given an ounce of water two or three times each 
day. (All water given the baby should be boiled 
and cooled) . At all times, give the water in a 
Hygienic nursing bottle. This gets the baby in the 
habit of taking the rubber nipple and when it is time 
to wean the baby the task becomes an easy one. 

Paragraph 341 

Do not forget to wash out the baby’s mouth 
once a day with a saturated solution of boracic 
acid. This should be done as long as the infant 
nurses. Also wash the nipples, before and after 
the baby nurses, with the same solution. It is very 
important. 

Paragraph 342 

If the baby has the colic during the first two 
or three months and cries a great deal, do not take 
up the baby every time it cries, and hold it. It is 
far better practice to change the baby’s position; 
that is, turn it on the other side, give it a little 
hot water—oftentimes it is necessary to use a 
glycerine suppository, or give an enema (colon irri¬ 
gation) to relieve the gas. To relieve gas from 
the stomach, when baby cries while nursing, or im- 


Page One Hundred Thirty-three 


LECTURES OF INTEREST TO WOMEN 


mediately after, hold baby up on your chest and ap¬ 
ply gentle friction- to its back. 

Paragraph 343 

Position of Mother and Child for Nursing. 
When nursing from the left breast, the baby should 
be held on its right side with its head-supported 
by the left arm of the mother. When nursing from 
the right breast, the position is, of course, re¬ 
versed, and the child lies upon its left side. 
Sometimes in the latter position, baby will vomit 
while nursing on account of the pressure of the 
liver on the stomach. If this vomiting occurs, let 
the baby lie upon its right side with its legs tuck¬ 
ed under the mother’s right arm. While the mother 
is in bed, she should lie on her side or be propped 
up with a pillow. After she is sitting up, she 
should lean a little forward while nursing, so that 
the nipple will point downward toward the child’s 
mouth. It will add greatly to the mother’s comfort 
if she rests her foot upon a stool. 

Paragraph 344 

Plow of the Milk. When the milk flows too 
freely and the child nurses too rapidly, the nipple 
should be withdrawn now and then to prevent its 
choking and to allow it to breathe, and at the same 
time restrain the rapid flow by passing the base of 
the nipple between the fingers and thumbs. Also 
hold the breast so as to keep it away from the baby’s 
nose. 

Paragraph 345 

When the flow is not free enough, and it is 
difficult for the infant to obtain sufficient nour-' 
ishment (especially with a delicate child) pressure 
of the hand on the breast will increase the flow of 
milk—nothing will do more to stimulate milk secre¬ 
tion and increase the flow than vigorous, nursing 
by a strong, healthy child. 

Paragraph 346 

One breast is generally sufficient for one 
nursing and the other is reserved for the next feed¬ 
ing. At first the quantity of milk a mother se¬ 
cretes is about one pint in 24 hours. This amount 


Page One Hundred Thirty-four 



CARE AND FEEDING OF INFANT 


of milk secreted increases as it is demanded by the 
growth of the child. 


Paragraph 347 

The flow of milk at first is generally more 
than the baby can digest. Nature prevents over¬ 
feeding (especially of strong babies) by the 
stomach rejecting an over supply. It comes up just 
as it went down. It is simply a spitting up, not a 
vomit, and milk so rejected does not have a very 
soui odor. When this occurs, and baby is healthy, 
the mother need not worry. She can correct this 
trouole by not allowing the baby to nurse so long. 

Paragraph 348 

The Amount and Quality of Mother’s Milk: When 
there is not a sufficient supply of milk to nourish 
the child, the question arises whether the amount 
can be increased. It will be necessary in such 
cases to give both breasts at a nursing; have the 
mother drink Large quantities of liquids like milk 
and.various milk foods. Have her partake freely 
of soups and other liquids. Beer is often good to 
increase the milk. There is a soft wine of differ¬ 
ent flavors made by the Imperial Non-Alcoholic 
Wine Company, of Seattle, Washington, that is very 
effective in increasing mother’s milk and it not 
only increases the quantity, but also seems to in¬ 
crease the quality of the milk. Now, suppose we are 
successful in increasing the amount of milk—are we 
increasing the nourishment for the child in a like 
ratio? Increasing the amount of milk does not 
necessarily increase its nourishing power. There¬ 
fore, the quantity of milk secreted may be larger, 
yet it may be more watery and the actual amount of 
nourishment in 24 hours may be just the same as be¬ 
fore—so the quality of the milk must be known. In 
all cases, frequent chemical analysis of the milk is 
imperative. The mother’s milk should show an an¬ 
alysis practically as follows: that is for all 
practical purposes, we may say mother’s milk con¬ 
tains : 

Paragraph 349 

Specific gravity.1020 to 1033 

Reaction ... Alkaline 


Page One Hundred Thirty-five 






LECTURES OF INTEREST TO WOMEN 


Fats . 

. 4% 

Proteids . 

. 2% 

Sugar . 

. 6% 

Bacteria . 

. Absent 

Water .. 

. 88% 

Supposing now, 

that we have some 


the amount or quality of the breast milk; can this 
be corrected before subjecting the baby to the 
trials of artificial feeding? While we cannot al¬ 
ways be positive of results, we do know that the 
kind and amount of food given the nursing mother, 
her habits of living, and frequency of nursing the 
baby, exert a powerful influence upon the com¬ 
position of the milk. This is accomplished'as fol¬ 
lows : 

Paragraph 350 

RULES FOR MODIFYING BREAST-MILK (RATCH) 

TO INCREASE THE TOTAL AMOUNT OF MILK: 

Increase the liquids in the diet and give 
soft non-alcoholic wines. 

Paragraph 351 

TO DECREASE THE TOTAL AMOUNT OF MILK: 

Decrease the liquids in the diet. 

Paragraph 352 

TO INCREASE THE TOTAL SOLIDS: 

Shorten nursing intervals; decrease exer¬ 
cise; and decrease the liquids in the diet. 

Paragraph 353 

TO DECREASE THE TOTAL SOLIDS: 

Lengthen the nursing intervals, increase ex¬ 
ercise, and increase the liquids in the diet. 

Paragraph 354 

TO INCREASE THE FAT : 

Increase the meat in the diet. 

Paragraph 355 

TO DECREASE THE FAT: 

Decrease the meat in the diet. 

Paragraph 356 

TO INCREASE THE PROTEIDS: 

Decrease the diet. 


Page One Hundred Thirty-six 








CARE AND FEEDING OF INFANT 


Paragraph 357 

TO DECREASE THE PROTEIDS: 

Increase the exercise to the point of fatigue. 

Paragraph 358 

By the term ‘‘Total solids,’’ we mean the 
total amount of FAT, PROTEIDS, SUGAR, and SALT. 

Every mother nursing her child should have 
the proper diet of digestible and nutritious foods 
and regular exercise. She should avoid late hours, 
and should be free from all worry, anxiety and 
nervous excitement. Her digestion must be in the 
very best condition. Regularity should govern the 
time for meals. She should eat slowly, masticate 
the food thoroughly, and keep the bowels regular. 

It is not so much what a nursing mother eats, 
as it is the way she eats it, and how perfectly it is 
digested, because indigestion in the mother in¬ 
variably causes indigestion in the child. True, 
such articles of diet as onions, turnips, cauli¬ 
flower and cabbage, with their distinct odors and 
tastes, may impart an unpleasant taste to the 
mother’s milk. In like manner, certain drugs taken 
by the mother will enter the milk and effect the 
child. No drugs should be taken by a nursing mother 
only as prescribed by a physician. You will remem¬ 
ber we discussed the subject of the nursing 
mother’s diet, and the taking of medicine by her, 
when considering her care after the confinement. 

A physician may treat a child in this way, yet 
the mother should be free from all anxiety regard¬ 
ing the effect on the baby of any medicine that may 
be prescribed by her physician. 

Now, let it be remembered that a nursing 
mother with perfect digestion, can eat nearly 
everything digestible without fear of affecting 
the baby. 

Paragraph 359 

THE WET NURSE: If, by any reason, the amount 
and quality of the mother’s milk is deficient, and 
the fault cannot be corrected, she does not neces¬ 
sarily have to wean the baby and resort to artifi¬ 
cial feeding, since she may employ a wet nurse with 
gratifying results. 


Page One Hundred Thirty-seven 




LECTURES OF INTEREST TO WOMEN 


Paragraph 360 

In delicate children, or in cases where arti¬ 
ficial food does not agree, remarkable gains will 
often quickly follow the employment of a wet nurse. 
In fact, in many cases it is the baby’s only chance 
for life. Now, the choice of a wet nurse is a matter 
of great importance, and the physician in charge 
should be consulted. The wet nurse should be a wo¬ 
man of good health, strong, and not too fat. Her 
blood should be examined to eliminate syphilis. An 
examination of the wet nurses’ own baby is a guide 
to the health of the mother and to the nutrient 
value of her milk. Her age should be between twenty 
and thirty years. The age of her baby should be as 
near the age of the one she nurses as possible—it 
is to some advantage if her own baby is a few weeks 
the older. Her breasts should be firm and contain 
plenty of milk. If possible, the wet nurse should 
only nurse her foster infant, because few women 
have enough for both, and a mother will naturally 
give the preference to her own child. 

Paragraph 361 

She should be a woman of good moral char¬ 
acter, amiable, temperate and should have a sense 
of the responsibility of her position. A married 
woman is to be preferred—yet there is no objection 
to an unmarried woman, providing it is her first 
baby. It is only the neglect of a wet nurse, and not 
her moral vices, which affects her foster child. 

For the same reason, the color of the nurse is a mat¬ 
ter of no consequence whatever. Rules regulating 
the wet nurse’s health are the same as those for a 
nursing mother. There are great difficulties in 
obtaining a gobd wet nurse, and, no matter how well 
qualified she may seem, a wise mother will not hand 
over the care of her baby entirely to the nurse, but 
will exercise a careful supervision over every¬ 
thing that goes on, particularly at night. 

This brings us to the next subject of infant 
feeding—that of artificial feeding, and let us say 
to you that artificial feeding of infants will be 
the most perplexing and difficult problem in all 
your work relative to the care of children. It pre- 


Page One Hundred Thirty-eight 



CARE AND FEEDING OF INFANT 


sents itself for the combined effort and study of 
physician, nurse, and mother. 

Paragraph 362 

ARTIFICIAL FEEDING OF INFANTS: In the feed¬ 
ing of infants with artificial foods, modified 
cow’s milk is considered the best. True, various 
infant foods are on the market and all have some 
value, but cow’s milk is by all means the most im¬ 
portant, and, for that reason, we shall consider 
the use of cow’s milk very thoroughly. 

Paragraph 363 

Selecting the Milk for Infant Feeding: In 
selecting good cow’s milk, two important factors 
exist: 

1. Cleanliness. 

2. The health of the herd. 

The best milk for infants is herd milk, and 
not from one cow. Jersey milk is not to be recom¬ 
mended at all on account of being too rich in fats 
and the delicate constitution of the breed, which 
predisposes them to tuberculosis. Therefore, 
every cow furnishing milk for infant feeding should 
be tested for tuberculosis. Possibly, this is a 
hard law to enforce, but every precaution possible 
should be taken in this direction. 

Paragraph 364 

The stable in which cows are kept should be 
located on high ground and it should be well ven¬ 
tilated and clean, and the cows themselves should 
be kept clean, and the udders well washed before 
each milking. The cow’s food should never consist 
•of brewery refuse, etc. The attendant, or milker 
should be healthy and free from all infectious dis¬ 
eases, and he should keep himself scrupulously 
clean and should wash his hands, before each milking 
—such precautions can be taken by any reasonable, 
intelligent, individual, and will add greatly to 
the cleanliness of the milk. 

Paragraph 365 

The milk should be collected in containers 
that have been sterilized and immediately, if pos- 


Page One Hundred Thirty-nine 





LECTURES OF INTEREST TO WOMEN 


sible, packed in ice, then sealed and kept in this 
condition until delivered. 

A great factor in securing a pure milk for 
infants’ use is the period of time which elapses be¬ 
tween milking and delivery. The shorter the 
period, the cleaner the milk when it is ready for 
use. The number of bacteria per cubic centimeter 
should not be over twenty to thirty thousand, pre¬ 
ferably not over ten thousand. 

Paragraph 366 

The milk should be free from all and any 
preservations, and must not contain any pathogenic 
micro-organisms. It must contain the various 
constituents in required amounts. 

Paragraph 367 

Let us note the difference between cow’s milk 
and human milk. Cow’s milk contains two or three 
times as much proteid as human milk. Therefore, 
cow’s milk would have four to six per cent proteid 
and it occurs in two forms. 

Paragraph 368 

CASEIN AND SOLUABLE PROTEID—Soluable 
proteid is the most easily digested of all forms of 
albumin, and it is present in a greater amount in 
. human milk than in cow’s milk. 

The casein in cow’s milk is not coagulated 
by heat, but is thrown down in the form of curds by 
acid or rennin. 

Cows milk contains about 1% more of total 
solids than human milk. 

Paragraph 369 

Sugar occurs as lactose.in both, but in human 
milk it is two or three times more abundant than in 
cow’s milk, so in cow’s milk we would only have about 
two per cent sugar. 

The amount of fat is about the same, but human 
milk contains a greater proportion of fat with a 
low melting point, and, therefore, it is easier to 
digest. 


Page One Hundred Forty 






CARE AND FEEDING OF INFANT 


Paragraph 370 

Human milk is alkaline in reaction and quite 
sterile, free from bacteria. Now cow’s milk is acid 
in reaction, caused by the bacteria it contains. 
Cow’s milk often contains two hundred million bac¬ 
teria per c. c. Under the most up to date aseptic 
conditions this may be limited to twelve thousand 
bacteria per c. c. 

Paragraph 371 

The approximate analysis of cow’s milk is as 
follows: 

Specific Gravity About 1030 

Reaction . acid 

Fat . 4% 

Proteids . 3.5% 

Sugar .. 4% 

Bacteria . present 

Water . 86 to 87% 

From the above you will note the composition 
of cow’s milk as compared with breast milk—there is 
quite a difference. The fats, sugar and proteids in 
cow’s milk are about the same—say, 4%. So to modify 
cow’s milk and make it like human milk, we must do 
two things: add more sugar and take out proteids. 

We supply the sugar in the form of sugar of milk, 
cane sugar, or the malt foods, and we take out the 
excessive proteids, or curd in the milk, by dilut¬ 
ing cow’s milk with water. 

Paragraph 372 

It is a fact that newly born animals are 
poorly supplied with such elements as to enable them 
to repel germ invasion, or to assimilate food. 
Experience teaches that in the infant this is an 
exception, that the same condition does not exist 
because the colostrum and early milk have the 
power of exciting a beneficial reaction in the in¬ 
fant’s tissue. Therefore it is very important in 
all cases, to have the baby nurse, if only for a few 
days, before artificial feeding is commenced. 

Now, the question confronts us, how can we modify 
cow’s milk so that it will have the same amount of 
fat, proteids, and sugar as contained in human 
milk? 

This is not so difficult when we know the ex- 


Page One Hundred Forty-one 











LECTURES OF INTEREST TO WOMEN 


act composition of each. We know that there is 
two or three times as much proteid in cow’s milk 
as in human milk. We know that the fat is about the 
same, and that human milk contains two or three 
times as much sugar as the cow’s milk. That the 
curd in the cow’s milk is much larger and occurs in 
harder masses than in the human milk, and we learn 
from experience that barley water mechanically 
divides up the curd of cow’s milk. We also know 
that citrate of soda, one grain to every ounce of 
milk, or the use of lime water or bicarbonate of 
soda in the place of barley water, makes the curd 
softer and helps to prevent their formation and 
renders it more like human milk. We also know that 
cow’s milk contains bacteria which gives it an 
acid reaction, and we know that the human milk is 
alkaline and free from bacteria. We also know that 
the fresher the cow’s milk is, the weaker the acid 
reaction, and the less bacteria present. We also 
know that many of the bacteria contained in cow’s 
milk can be destroyed by having, the milk pasteurized 
or sterilized, thus rendering it fit for infant 
feeding. 

Paragraph 373 

From this knowledge let us formulate a mix¬ 
ture that will represent human milk as near as 
possible, and a mixture that will be the most con¬ 
venient and easy to make up. One that can be used 
if necessary from birth, when the child has not 
received any breast feeding. 

Whole Milk.134 Ounces. 

Cream (15%) . 1 ’ ’ 

Lime water ....... 34 

Sugar of milk water . 134 ’ ’ 

Citrate of soda.,.. r .3 Grains. 

What does this mixture contain? 

FIRST: 134 ounces of whole milk, and what we 
mean by whole milk is the contents of the bottle of 
milk after it is thoroughly mixed. 

SECOND: 1 ounce of cream which contains 15% 
fat. This cream is taken from the regular bottle of 
milk, and not from the one used for whole milk. 

THIRD: 34 ounce of lime water. It is used as 


Page One Hundred Forty-two 










CARE AND FEEDING OF INFANT 


mentioned to break up the curds in the cow’s milk, 
and help to dilute the proteids. 

FOURTH: 1% ounces of sugar of milk water. 
Sugar of milk can be obtained from any druggist, and 
to make the solution, put three ounces of sugar of 
milk to a pint of hot water. It should be placed in 
a bottle, well corked, after it has been pasteurized 
for 10 minutes. It should be made fresh every day. 

FIFTH: Citrate of soda. The citrate of soda 
is used to break up the curds, and render the milk 
less acid. 

Paragraph 374 

Barley water may be used as a substitute for 
lime water in the above formula, and it is made by 
using 1 level teaspoonful of Robinson’s prepared 
barley flour to 1 pint of boiling water, to which is 
added a pinch of salt. The flour should be stirred 
up with a little cold water before adding the boil¬ 
ing water; let it boil for an hour, strain through 
a fine strainer, and add enough boiling water to 
bring the quantity up to one pint. It is better to 
have the barley water made fresh every morning and 
evening. 

The cream which contains only 15% fat, used 
in the above formula, is obtained by setting aside 
a good quality.of cow’s milk for six hours, and skim 
off the cream, or it can be taken from the bottle of 
milk with a Chapin dipper. As a rule the cream from 
a dairy should not be used, as it contains too much 
fat. 

Paragraph 375 

When it is necessary to feed an infant from 
birth (who has had no breast feeding), we recom¬ 
mend the above formula for the first month. After 
that, begin with Formula No. 2 of other mixtures 
modifying cow’s milk. 

Now to give this mixture the first twenty- 
four hours, dilute it, using three parts of sterile 
water and one part of the mixture, and give four 
feedings six hours apart, using VA ounces for each 
feeding. 

Paragraph 376 

During the second twenty-four hours of the 


Page One Hundred Forty-three 






LECTURES OF INTEREST TO WOMEN 


baby’s life give the same diluted mixture, only 
give six feedings. Now, this diluted mixture for 
the first few days is intended to roughly take the 
place of the colostrum. On the third day, and 
thereafter, this mixture undiluted is to be given 
as an exact substitute for breast feeding as re¬ 
gards time and amount. 

Paragraph 377 

Infants up to one month old, as a general 
rule, will do as well, if not better, on this mix¬ 
ture than on any other method of artificial feeding. 
This mixture should always be pasteurized before it 
is used. The quantity required for the first 
month will be from one and one-half to two and one- 
half ounces for each feeding. 

Paragraph 378 

Therefore, in order that you thoroughly un¬ 
derstand the giving of this mixture during the first 
month, let us repeat what was just said, giving 
more details. Now, as we said for the average 
infant, begin the first day with VA ounces properly 
diluted, and feed the infant every six hours. The 
second day feet it every four hours, giving the same 
diluted amount —VA ounces. On the third day feed 
it every four hours, giving the same amount —VA 
ounces—as the first and second days, only on the 
third day the mixture is not diluted. After the 
third day, feed the infant every three hours (at 6, 
9, 12 and 3) , and every third day increase the amount 
of food, to be given in the 24 hours, 1 drachm (which 
equals 1 teaspoonful). That is, on the third day 
the infant is getting 9 ounces of the mixture in 24 
hours, or six feedings of VA ounces each. On the 
sixth day you would add 1 drachm to the 9 ounces, so 
it would be getting 9 ounces and 1 drachm in the 24 
hours for three days, on the ninth day add another 
drachm, making 9 ounces and 2 drachms, and so on. 
With this increase of 1 drachm every third day, by 
the end of the first month the infant will be taking 
2A ounces at each feeding. 

Now we have taken the baby through the first 
month of its feeding and this is the critical time. 
If we can only have a baby nurse the first month, 


Page One Hundred Forty-four 



CARE AND FEEDING OF INFANT 


so much, the better. 

Paragraph 379 

The artificial feeding of infants from now 
on is not so difficult providing the baby has got a 
good start and making the necessary gain, because 
after the first month, the digestion of the infant 
is not so delicate as it is commonly supposed to be. 
Some authorities give whole milk without any 
dilution, but you must give the baby plenty of 
water between feedings. It is this line of feed¬ 
ing with whole milk that is used in the Rotunda Hos¬ 
pital . 

Paragraph 380 

After the infant is 2 or 3 months old, we can 
easily estimate quite accurately the amount of 
nourishment and milk required to obtain the de¬ 
sired results. There are heat units in all foods 
known as calories. 


Paragraph 381 

An infant requires from 40 to 45 calories 
per pound weight. Thus, if a baby weighs 12 
pounds, it would require 480 calories or heat 
units every 24 hours. In one ounce of milk there 
are 21 calories, and to give the infant the neces¬ 
sary food requires an ounce and one-half of milk 
per pound. The child who weighs twelve pounds 
would require 18 ounces of milk. We are going to 
give 6 feedings of 5 ounces each, which would be 30 
ounces required in the 24 hours. We are going to 
use 18 ounces of milk; therefore, we have 12 ounces 
of water. We can use barley-water, oatmeal water, 
rice water, romanmeal water, or use plain sterile 
water, as the case may require, to dilute the milk. 
As we are using 18 ounces of milk we must multiply 
18 by 21, which will equal 378 calories or heat 
units, but we must supply the difference to make 
up the 480 calories, the amount required for an in¬ 
fant that weighs 12 pounds. This we do by adding 
sugar of milk, cane sugar, malt sugar, or some of 
the malt foods. The sugar of milk is possibly used 
as much as any of the others and it contains 110 
calories to the ounce. Therefore, in a 30 ounce 
mixture we are going to add one ounce of milk sugar. 


Page One Hundred Forty-five 






LECTURES OF INTEREST TO WOMEN 


If we use barley water, or any of the other waters 
mentioned in place of plain water, for every ounce 
of barley, oatmeal, rice or romanmeal, we would 
get in the neighborhood of 100 calories for every 
ounce of food stuff so used. Therefore, we would 
not require so much sugar of milk, cane sugar, or 
malt sugar, whichever one is used. 

Paragraph 382 

How many understand this method of estimating 
the amount of food required every 24 hours for an 
infant? Not one of you. Well, to make it clear, you 
must know these four facts, or rules. 

First—Calories are heat units. 

Second—Each ounce of milk contains 21 
calories. 

Third—The average infant requires 40 cal¬ 
ories every 24 hours for each pound it weighs. 

Fourth—An infant should have VA ounces of 
milk every 24 hours for each pound it weighs. 

Paragraph 383 

Let us illustrate it in figures this way: Now 
suppose the infant is four to six.months old and 
weighs 12 pounds—12 pounds times 40 calories equals 
480 calories, or the number of heat units an infant 
requires every 24 hours. We multiply 12 by 40 be¬ 
cause the average infant must have 40 calories for 
each pound it weighs. 

Paragraph 384 

Now to find the amount of milk to be given in 
24 hours to an infant weighing 12 pounds, we mul¬ 
tiply 12 by 1% ounces, which equals 18, giving us 
the number of ounces of milk required for an infant 
weighing 12 pounds, which is 18 ounces. 

Now we say each ounce of milk contains 21 
calories, so if we multiply 18 by 21 it will give us 
the number of calories, or heat units, that is con¬ 
tained in 18 ounces of milk, which equals 378 cal¬ 
ories, or heat units. We lack the difference between 
378 and 480—that is, we subtract 378 from 480, 
which equals 102. So we must, in some way, make up 
the 102 calories. 


Page One Hundred Forty-six 



CARE AND FEEDING OF INFANT 


Now we must feed the infant six times, and we 
are going to use 5 ounces at each feeding, so five 
times 6 equals 30, or the number of ounces of fluid the 
infant will take in 24 hours. We are going to use 
18 ounces of milk, and 18 from 30 equals 12, the 
number of ounces to be supplied. 

The 12 ounces of fluid to be added to the 18 
ounces of milk may consist of any one of the cereal 
foods like barley water, rice water, or oatmeal 
water. Any of these cereals equal about 100 to 110 
calories per ounce. Therefore, an ounce of any one 
of them added to the 18 ounces of cow’s milk will 
make up the required amount of calories. Plain 
sterile water, with the addition of sugar of milk 
may be used, because one ounce of the sugar of milk 
equals about 110 calories. Malt foods may also be 
used, and they give about the same number of calories 
per ounce. Therefore, you see we can use an ounce of 
any of the above foods, and when added to the milk 
will give us 110 calories to be added to the 378 
calories, which will equal 488, the number of heat 
units required to nourish a child from 4 to 6 months 
old, weighing 12 pounds. It is not necessary that 
the amount of calories be just the exact number, a 
few more or less would not make any material differ¬ 
ence, and it must be remembered that this estimate 
is the average, because a delicate child would not 
require the same amount of heat units that a robust 
child would. Every infant to be fed is a law unto 
itself, and we must be governed accordingly. If 
you have any difficulty in arranging the right 
formula, your physician will assist you. 

The rule that we have just given you, to esti¬ 
mate the amount of food required for a child who 
weighs 12 pounds, can be applied to any infant ac¬ 
cording to its weight. 

Paragraph 385 

There is a preparation made by Mead and 
Johnson known as Dextrimaltose, which is very ef¬ 
ficient and contains about 120 calories per ounce, 
and can be used to supply the sugar to a great ad¬ 
vantage in place of the sugar of milk. Dextri¬ 
maltose takes the place of lime water or citrate of 
soda to break up the curds in cows milk. 


Page One Hundred Forty-seven 





LECTURES OF INTEREST TO WOMEN 


Paragraph 386 

Dr. Fischer gives, in his recent work, a 
chapter devoted to the feeding of children, and 
gives a very complete set of formulas to be used 
from birth to 12 months, using Dextrimaltose in 
combination with whole milk and plain sterile water, 
and we will give them to you as contained in his book, 
as they are probably the most simple to prepare, and 
make an excellent formula. In some cases it may be 
necessary, and the physician may order lime water 
to be added in combination with the Dextrimaltose 
mixture. We recommend these formulas, and advise 
that you use them at the beginning of any case where 
you wish to give artificial food after the first 
month. During the first month, as suggested, use 
the formula especially prepared for the first 
month, which we have already given you. The formulas 
are as follows: 


Paragraph 387 

FORMULA NO. 1—(For an infant from birth to three 

weeks old, weighing about 7 pounds, require¬ 
ment 318 calories): 


R/ Whole milk .13 ounces 

Hot water.12 ounces 

Dextrimaltose ... 4 drachms 


Mix thoroughly and heat in a saucepan until 
steam rises. Continue steaming at same tempera¬ 
ture, for five minutes, being careful not to allow 
it to boil—this is one way to pasteurize the milk 
—then divide it into ten bottles of 2 Yz ounces each. 
Feed every three hours. Insert large stoppers of 
non-absorbent cotton in the necks of the bottles. 
Place in a refrigerator, but not on ice. Warm be¬ 
fore feeding by placing bottle into a deep saucepan 
of hot water and keep it there until the food reaches 
body temperature. 

Another way to pasteurize the modified milk 
is—after making up the entire mixture, set it away 
in a pitcher in the refrigerator, the same as men¬ 
tioned above for the individual bottles, and then 
when it is time to feed the infant stir up the mix¬ 
ture thoroughly, and pour the required amount in a 
nursing bottle and place it in a vessel of cold 

Page One Hundred Forty-eight 






CARE AND FEEDING OF INFANT 


water, and have the water deep enough in the vessel 
so that the bottle is two-thirds covered when set in 
it. Bring the water to a good boil, then take the 
vessel off the fire and let the bottle remain in the 
hot water for 20 minutes, after which time it will 
be about the right temperature to feed the baby. If 
necessary, cool it by letting cold water run on the 
bottle until it is the required temperature. 

Paragraph 388 

FORMULA NO. 2 (For an infant from three wee'ks to six 
weeks old, weighing about 8 pounds, require¬ 
ment 364 calories): 

R/ Whole milk ...>..14 ounces 

Hot water....10 ounces 

Dextrimaltose . 6 drachms 

FORMULA NO. 3 (For an infant from six weeks to two 

months old, weighing about 10 pounds, require¬ 
ment 455 calories): 


R/ Whole milk . 17 ounces 

Hot water. 15 ounces 

Dextrimaltose . 1 ounce 


Divide in eight feedings of 4 ounces each. 
Feed every three hours. 

FORMULA NO. 4 (For an infant from two to four months 
old, weighing about 11 pounds, requirement 
500 calories): 


R/ Whole milk .19 ounces 

Hot water.16 ounces 

Dextrimaltose . 1 ounce 


Divide into seven feedings of 5 ounces each. 

FORMULA NO. 5 (For an infant from four to six months 
old, weighing about 12 pounds, requirement 546 


calories): 

R/ Whole milk .22 ounces 

Hot water.14 ounces 

Dextrimaltose . 1 ounce 


Divide into six feedings of 6 ounces each. 

Feed every three and one-half hours. 

FORMULA NO. 6 (For an infant from six to nine months 
old, weighing about 14 pounds, requirement 
637 calories): 

R/ Whole milk .26 ounces 


Page One Hundred Forty-nine 

















LECTURES OF INTEREST TO WOMEN 


Hot water.14 ounces 

Dextrimaltose . 1 ounce 

Divide into five feedings of 8 ounces each. 
Feed every four hours. 

FORMULA NO. 7 (For infants from nine to twelve months 
old, weighing about 17 pounds, requirements 
773 calories): 


R/ Whole milk .35 ounces 

Hot water....'. 5 ounces 

Dextrimaltose . 6 drachms 


Divide into five feedings of 8 ounces each. 
Feed every four hours. 

Paragraph 389 

Dr. Holt, of New York, gives a very complete and 
comprehensive formula modifying cow’s milk using 
milk, cream, limewater, water and milk-sugar. 

The milk should be whole milk, and the cream 
skimmed off the top of the whole milk. Do not skim 
the cream off and then consider that you are using 
whole milk. Whole milk must contain all the cream 
and milk. 

We will give you these formulas, so if they 
should be prescribed by the physician or you wish to 
use them for any special reason you will have them. 


Paragraph 390 

FORMULA NO. 1 (Third to Fourteenth Day) : 

Milk. 1 to 2 ounces 

Cream . 1 to 2 ounces 

Limewater...—.1.% to 1% ounces 

Water . 9% to 18% ounces 

Milk-sugar (even table¬ 
spoonfuls). 1% to 3 ounces 

Ten feedings. Feed every two hours from 6 
a.m. to 10 p.m. Feed also at 2 a.m. Quantity, 1 to 
2% ounces. 

FORMULA NO. 2 (Second to Sixth Week): 

Milk... 2 to 3% ounces 

Cream ..... 2 to 3% ounces 

Limewater. 1% to 2 ounces 

Water .14% to 23% ounces 

Milk-sugar (even table¬ 
spoonfuls) ... 2% to 4 ounces 


Page One Hundred Fifty 



















CARE AND FEEDING OF INFANT 


Ten feedings. Feed every two hours from 6 
a.m. to 10 p.m. Feed also at 2 a.m. Quantity, 2 to 
3% ounces. 


FORMULA NO. 3 (Sixth to Eleventh Week): 


Milk. 3 to 4^ ounces 

Cream . 3 to bounces 

Limewater .1% to 1 % ounces 

Water .16 Vz to 25% ounces 

Milk-sugar (even table¬ 
spoonfuls). 3 to 4% ounces 

Eight feedings. Feed every two and a half 


hours from 6 a.m. to 10 p.m. Feed also at 2 a.m. 
Quantity 3 to 4% ounces. 

FORMULA NO. 4 (Tenth Week to Fifth Month): 


Milk.— 8 to 12 ounces 

Cream . 3% to 5 ounces 

Limewater. 1% to 2 ounces 

Water .—15 to 23 ounces 

Milk-sugar (even table¬ 
spoonfuls). 3% to 5% ounces 

Seven feedings. Feed every three hours from 


6 a.m. to 10 p.m. Feed also at 2 a.m. Quantity 4 
to 6 ounces. 


FORMULA NO. 5 (Fifth to Tenth Month): 

Milk. 11% to 18 ounces 

Cream . 3% to 6 ounces 

Limewater... 1% to 2 ounces 

Water .13% to 22 ounces 

Milk-sugar (even table¬ 
spoonfuls). 4 to 6% ounces 

Six feedings. Feed every three hours from 
6 a.m. to 10 p.m. No feeding between 10 p.m. and 6 
a.m. Quantity, 5 to 8 ounces. 


FORMULA NO. 6 (Tenth to Twelfth Month): 

Milk.19% to 21% ounces 

Cream ... 5% to 6% ounces 

Limewater.- 2 to 2 ounces 

Water .15 to 18 ounces 

Milk-sugar (even table¬ 
spoonfuls). 4 to 5 ounces 

Five feedings. Feed every three and a half 
hours from 6 a.m. to 10 p.m. Quantity, 2 to 9 ounces. 


Page One Hundred Fifty-one 























LECTURES OF INTEREST TO WOMEN 


Paragraph 391 

In this connection we might state that there 
are other combinations than the ones just given, but 
these are in general use by physicians, and to give 
you too many formulas would be confusing. Some 
physicians prescribe what is known as ‘‘Top-Milk 
Mixtures’’, and what we mean by ‘‘Top-Milk Mix¬ 
tures’’ is the upper portion of a quart of nfilk set 
aside until the cream layer separates. The per¬ 
centage of fat in the top-milk is estimated from 
4 ounces to 24 ounces, and contains from 5 to 20% of 
fat respectively. Some physicians use various 
amounts of this top-milk in combination with the 
bottom-milk, adding lime water, sugar milk and 
plain water in required proportions. The top-milk 
is always dipped-off with the Chapin dipper. The 
physicians who use these formulas will give you 
special instructions in regard to the manner and 
amount with which the food is prepared. 

Paragraph 392 

Make an increase in the formulas every seven 
or eight days until the full amount of each ingre¬ 
dient is reached at the end of the given time. If 
you are using Formula No. 3 of Holt’s, at the begin¬ 
ning of the sixth week you would use 3 ounces of 
milk, and each week you will increase it until the 
eleventh week you would be giving 4 l A ounces, and all 
other ingredients would be increased in like pro¬ 
portion. For the water in any of the Holt for¬ 
mulas, you can use barley water, rice water, as is 
indicated in any given case. This increase in the 
amount of food applies to any formula you may be 
using. 

Paragraph 393 

Now in the artificial feeding of infants, 
every case is a law unto itself. No fixed rules can 
be laid down that can be used indiscriminately and 
applied to any case. We must take into considera¬ 
tion the health of the child, its physical condi¬ 
tion, the time that we start the artificial feeding, 
and condition of the bowels and the facilities that 
are at hand to carry out the necessary success of the 
artificial feeding. However, we must recognize the 


Page One Hundred Fifty-two 





CARE AND FEEDING OF INFANT 


needs and the kind of feeding required in each case. 
Suppose the child has been taking Eagle Brand for two 
or three months, and we find a. baby that is fat, 
white and puffy, we know that the -diet must be 
changed, so we will place the baby on a modified milk 
formula according to its age and condition. 

Paragraph 394 

If we find a child suffering with constipa¬ 
tion, you will add Phillips’ Milk of Magnesia, one- 
half to one ounce, to the whole mixture, so as to 
get a small amount in each feeding. If you are 
called upon to care for a baby that is nursing, 
losing weight all the time, sucks its fingers, cries 
after nursing, is fretful, you know the child is not 
getting enough food, and we must add a modified milk 
to its diet, and if the mother can continue to nurse 
the baby two or three times a day, we give what is 
known as mixed feeding. 

Now with these suggestions, you will under¬ 
stand what we mean when we say that no fixed formula 
can be written that will apply to every case.' With a 
little study on your part, noting the action of 
the different foods and different combinations and 
the results obtained in each, as you will learn in 
your practice, you will soon become very efficient 
in selecting and preparing the food that will meet 
the requirements in any given case that you may have 
under your care. 

Paragraph 395 

You will find that some children will do well 
on one combination, and it will not agree with an¬ 
other. You must learn from experience to select 
and prepare the right combinations to meet the re¬ 
quirements. Before we pass to the preparation of 
the formulas just given, using modified cow’s milk, 
let us mention the patent infant foods on the market. 

Paragraph 396 

There are a great many in number, but none of 
them are as good as modified cow’s milk for con¬ 
tinued use. They all have their advantages and dis¬ 
advantages and we cannot recommend their exclusive 
use. Occasionally we may find a case where modi- 


Page One Hundred Fifty-three 






LECTURES OF INTEREST TO WOMEN 


fied cow’s milk does not seem to agree with the 
child. Such prepared foods will give temporary 
relief, but must not be given for any length of time. 
Suppose, for example, we have used a food that seem¬ 
ingly makes good fat, and baby increases in weight 
rapidly, and you think you are having good success. 
The child develops to the point where it begins to 
walk, and all of a sudden it starts to lose weight, 
and takes on a white, waxy color. It cannot stand 
on its feet, and we have a case of rickets to contend 
with. Any physician who has practiced medicine will 
tell you that they often come in contact with such 
cases, caused by an exclusive diet of some of the 
patent foods. Therefore, many a case of rickets, 
or scurvy, can be traced to the giving of such foods. 
Yet we know that there are some virtues in these 
patent foods, and to attribute all cases of rickets 
and scurvy to this one cause is wrong, because chil¬ 
dren who are fed on sterilized milk will have 
scurvy, and a great many facts must be considered 
before condemning or praising one or all of the 
many patent foods. Anyone can understand that 
there are a large amount of these foods sold, and 
there are many good reasons why this is true. 

FIRST: Because the laity are.educated to use 
them when breast-feeding or cow’s milk does not 
agree with the child; 

SECOND: Some physicians advocate the use of 

a great many patent foods, because they are pre¬ 
scribed with less effort on their part; 

THIRD: As a rule they are much easier to pre¬ 
pare and less trouble than the modified cow’s milk. 
This appeals to the mother; 

FOURTH: Because the cow’s milk modified by 

the addition of the foods, in many cases, yields 
good results. 

Paragraph 397 

There are two kinds of infant foods on the 
market. The ones that are combined with cow’s milk 
and those that are not. As fresh cow’s milk is with¬ 
out doubt the best food for infants ,we recognize 
the fact that the artificial feeding of infants 
with these patent foods should be used in connec- 


Page One Hundred Fifty-four 






CARE AND FEEDING OF INFANT 


tion with, and modified by fresh cow’s milk. When 
yon nse any of these foods, as may be prescribed by 
the attending physician, you will follow his direc¬ 
tions or the one you find on the wrapper which accom¬ 
panies the package. Some of them require that the 
cow’s milk should be boiled. 

Paragraph 398 

Let us impress upon your mind one thing: 
that is, that boiling cow’s milk kills its nutritive 
qualities and makes it unfit for infant feeding, 
and when boiled milk is given to an infant for any 
length of time it will invariably produce rickets, 
scurvy and constipation. You remember this— 
never give an infant boiled milk unless ordered to 
do so by the attending physician. 

Paragraph 399 

Let us direct our attention this morning to 
the selection and modification of cow’s milk for 
infant feeding, at the same time rendering it as 
pure as possible. This brings us to a very important 
point, and that is, destroying the bacteria in milk 
by the process of pasteurization and sterilization. 

Paragraph 400 

By the terms ‘‘pasteurization’’ and ‘‘steril¬ 
ization’ ’ we mean the heating of milk, at a given 
temperature for a given length of time. Pasteuri¬ 
zation is done by heating the milk for about twenty 
minutes to 140 degrees F. Sterilization is done by 
heating milk to the boiling point (212 degrees F) 
and keeping it boiling for twenty minutes. 

This must be thoroughly understood in order 
that we may be able to give the infant milk that is 
as free from bacteria as is possible to be obtained. 
All cow’s milk contains bacteria, and the longer 
the period from the time of milking until it is pre¬ 
pared for the infant, the more bacteria we will have 
to contend with. Therefore, the most important 
point is to have the milking done under the best 
sanitary conditions and have it immediately deliv¬ 
ered to the consumer. This gives us as pure milk as 
can be obtained. Some people have the idea that it 
does not matter how filthy the cow’s milk is, or how 


Page One Hundred Fifty-five 



LECTURES OF INTEREST TO WOMEN 


long it is standing (just so it is sweet), or how 
many germs it may contain, if it be pasteu 'ized or 
sterilized it will become free from germs and it 
will be suitable food for infants. This is not 
true, because pasteurization and sterilization 
does not kill the spores of all bacteria. 

Paragraph 401 

THE PASTEURIZATION OF MILK: To pasteurize 
milk it must be heated to a temperature from 140 to 
160 deg. F. for 20 minutes, which answers all prac¬ 
tical purposes, and causes very little, if any, 
change in the chemical character of the milk, and 
nothing whatever as to taste. 

The pasteurization of milk is more desirable 
than sterilization, and we have very good authority 
that if we take pure milk and heat it to the point of 
pasteurization, it will destroy tubercle bacilli, 
typhoid and cholera bacillus , as well as pneumococcus, 
and also most of the ordinary milk germs. Let it be 
remembered that constipation, scurvy and rickets 
are recognized and associated factors when over¬ 
pasteurized milk is fed to infants. The profession 
are rapidly departing from what they claim to be im¬ 
proper and dangerous methods of treating raw milk 
on account of such conditions developing, which 
allow children to enter into womanhood and manhood 
in a marked devitalized condition. The day may be 
close at hand when pasteurized milk will be consid¬ 
ered the same as sterilized milk, and the use of both 
pasteurized and sterilized milk will be discon¬ 
tinued. Yet today Fischer says you should pasteur¬ 
ize cow’s milk if you do not know the source of your 
milk supply. 

Paragraph 402 

THE STERILIZATION OF MILK: To sterilize milk 
in order to destroy pathogenic bacteria, according 
to Soxhlet, we must heat milk to temperature of 210 
deg. F. and continue it at this temperature for 20 
minutes. This intense heating causes marked 
changes to take place in the milk; some we understand 
and others we do not, but we do know that it makes 
the milk more difficult to digest, that it is not 
acted upon the same by the gastric juices, and the 


Page One Hundred Fifty-six 







CARE AND FEEDING OF INFANT 


free fat present in sterilized milk is not properly 
assimilated by the infant. Then we know that ster¬ 
ilized milk was introduced to the profession by 
Soxhlet. It had many advocates and thousands of 
babies have been brought up on steriliezd milk, but 
today the sentiment has changed. We admit that 
sterilized milk destroys bacteria, it also destroys 
the quality of the milk at the same time. We also 
know that sterilizing milk does not kill all the 
spores of pathogenic bacteria, and infants fed on 
sterilized and boiled milk develop scurvy, rickets 
and constipation. On account of such conditions 
developing after the prolonged feeding of steril¬ 
ized milk and boiled milk, and knowing the immediate 
improvements that follow when the diet is changed 
to raw milk, beef juice, raw white of egg, fresh 
fruit juices, Fischer says in his latest book: ‘‘In 
my opinion I have so frequently been disappointed in 
the use of sterilized milk that within the last few 
years I have entirely discarded its use. 5 5 

Paragraph 403 

It will be well to remember that infants fed 
either on pasteurized or sterilized milk have a ten¬ 
dency to constipation, scurvy and rickets. The 
symptoms will not be so marked in cases of infants 
fed on pasteurized milk, as those on sterilized 
milk. In other words, pasteurization and sterili¬ 
zation of milk has its disadvantages as well as its 
advantages. We must pasteurize milk when we do not 
know the source of our milk supply and during the hot 
summer months. 

There are a great many apparatuses for the 
pasteurization of milk. If you so desire, you can 
have your patients purchase one of the outfits, and 
follow the directions which accompany them, but for 
all practical purposes, if you will take the milk 
and heat it for twenty minutes to the steaming point 
(not boil it), you will pasteurize the milk, which 
will answer all practical purposes in artificial 
infant feeding. 

Paragraph 404 

We have also given you a way to pasteurize 
milk by placing the bottle containing the milk in a 


Page One Hundred Fifty-seven 






LECTURES OF INTEREST TO WOMEN 


deep vessel, and bringing the water to the boiling 
point. If you will prepare your milk in this way, 
you will heat it to a sufficient temperature to 
pasteurize it, and at the same time you will not 
cause any changes to take place in the milk. Per¬ 
sonally we recommend that you use this method for - 
pasteurization of modified cow’s milk. 

Paragraph 405 

Fischer says: Let it be distinctly understood 
that certain chemical changes are brought about in • 
milk v/hen it is steamed, be it in the process of 
sterilization or pasteurization. Neither sterili¬ 
zation or pasteurization adds to the digestibility 
of milk. 

Paragraph 406 

In selecting cow’s milk for feeding infants 
we must obtain fresh milk and herd milk, that is, 
milk from several cows. If the milking is done, as 
directed, and in a short time the milk is placed on 
ice, in a refrigerator, or a cool place and kept at 
a low temperature until it is thoroughly cooled and 
the cream is formed and then immediately modified 
for the infant’s food, as desired, it will not re¬ 
quire any pasteurization and sterilization. When 
we obtain such certified milk all that is necessary 
is to use sterile utensils and heat the milk to a 
little higher temperature than is required for 
infant feeding, as we have just personally in¬ 
structed you to do. 

Paragraph 407 

CARE AND SELECTION OF NIPPLES AND BOTTLES. 

A rubber nipple which approaches the human 
breast-nipple in shape and action is the best one, 
and for this the ‘‘Hygeia’’, either the old or the 
improved anti-colic style, is the best. Also the 
‘‘Hygeia’’ bottle is recommended. There should be 
several of each on hand, both bottles and nipples, 
so as to allow for perfect sterilization between 
feedings. 

Paragraph 408 

Immediately after the child has nursed, the 
bottle and nipple should be carefully washed, first 
in cold water and then hot water. It is well to 


Page One Hundred Fifty-eight 



CARE AND FEEDING OF INFANT 


allow the bottles to stand with water in them, or you 
can place them in the solution with the nipple. The 
nipples, after being washed and sterilized, should 
be placed in a covered glass or jar kept for that pur¬ 
pose containing bicarbonate of soda solution. 

Paragraph 409 

This solution is made by using one tablespoon¬ 
ful of bicarbonate of soda to the quart of boiling 
water. The solution should be made fresh every day. 
You will need only one or two nipples ready to use at 
a time. Those made of black rubber are the best. 

We cannot say how long the average rubber nipple will 
wear, as boiling softens them. You must be careful 
to see that the opening in the nipple is the correct 
size so that the milk does not flow too slowly or too 
quickly. Some have a very small opening, which can 
be enlarged with a large needle. When the opening 
allows the milk to flow too freely and the nipple 
becomes too soft it should be discarded. 

Paragraph 410 

It is a great convenience to have enough 
bottles for the 24-hour feeding and fill them all 
at once. After each bottle is filled with the re¬ 
quired amount of milk for a feeding, they are prop¬ 
erly covered and placed in the refrigerator. At 
each feeding all that is necessary is to set the 
bottle in a pan of cold water and warm it to the re¬ 
quired temperature. At the same time boil the 
nipple in a separate basin. After the nipple is 
placed on the bottle the milk should be thoroughly 
mixed before given to the infant. Each morning be¬ 
fore the bottles are filled with the milk they 
should be thoroughly sterilized, and this is usual¬ 
ly done by filling the bottles with cold water, 
placing them in a kettle of cold water and allowing 
them to boil for twenty minutes. Put the nipples to 
boil in the same water. The bottles and nipples 
should be allowed to cool before removing from the 
kettle. 

Paragraph 411 

THE INTESTINAL TRACT (THE BOWELS): If we are 
to keep the baby well and its general health in good 
condition, we must see that the bowels move regular- 


Page One Hundred Fifty-nine 




LECTURES OF INTEREST TO WOMEN 


ly. They should, if possible, move twice a day, 
night and morning, until the child is two years old. 
You should train the baby to have a regular hour in 
the morning and a regular hour in the evening from 
birth. Some mothers will not take the trouble to do 
this, but it is of great importance to the child’s 
health, and this should be .done, and you must con¬ 
vince the mother of the necessity of forming regu¬ 
lar habits in the infant. 

Paragraph 412 

Make the baby’s bowels move. We are all 
creatures of habit, and if a regular time is estab¬ 
lished twice a day from the day of birth, it will 
soon fall into the habit. The best time for the 
morning movement is just before its bath. Infants’ 
bowels should not move immediately after feeding, 
because it has a tendency to regurgitate the feed¬ 
ing. After the baby is one year old, this is not so 
important. The best time for the evening movement 
is just before the baby goes to bed, immediately pre¬ 
ceding his evening feeding. To cause the bowels to 
move, place the baby on its back on your lap, with 
its feet elevated. You do this by holding the feet 
and legs up with one hand and leaving one hand free. 
Place a rubber sheet over your lap and a napkin 
under the baby’s buttocks. If it does not move its 
bowels in a minute or so, place a little vaseline on 
the tip of a clean finger and slightly irritate the 
baby’s rectum. Keep the finger there a few minutes, 
but be careful the fingernail does not injure the 
parts. This will often cause a movement. Let the 
baby know it is there to move its bowels. If this 
method does not produce the desired effect, it will 
be necessary to resort to the use of a soap stick or 
a glycerine suppository for infants. The soap stick 
can be made from Castile soap and should be the same 
shape, only about twice the size in diameter and 
half as long, as the glycerine suppository for in¬ 
fants you obtain from the druggist. Take one of the 
soap sticks and smear it with vaseline upon the 
small end and introduce it into the baby’s rectum. 
Keep it there until the contents of the bowels come 
away and push it out. You may use either the soap 
stick or glycerine suppositories. In using the 


Page One Hundred Sixty 






CARE AND FEEDING OF INFANT 


glycerine suppositories, they are held in'the rectum 
until the bowels move. It may be necessary to use 
one or the other several times before the baby will 
know what is expected. In some cases, they require 
the soap stick for a long time. There is no harm 
that can result from its continued use. The soap 
sticks can be used several times. They may be washed 
and when they become too small they can be discarded 
and a new one used. 

Paragraph 412 

After a baby is six months old it should be 
taught to use the vessel and sit on its nursery 
chair. Here you will be required to use the same 
methods of persuasion as practiced with the 
vaselined finger and soap stick, and it will accom¬ 
plish the same results. Have the nursery chair so 
arranged with an opening to put the hand under the 
seat, so when baby is sitting upon the fchair, the 
soap stick may be inserted into the rectum and held 
in position. Often using the finger, as mentioned 
above, will be effective. 


Paragraph 413 

INFANT STOOLS: You should be familiar with 
the appearance of a healthy stool, then you as a 
nurse can tell the normal from the abnormal. For a 
few days after birth, the stool is a dark color in 
all healthy babies. It will be necessary for you to 
change its napkin several times a day for a few days 
until this has entirely disappeared. After this the 
stools of an infant nursing the breast should have 
the appearance of yellow mustard. It should be free 
from all curds or lumps, smeary or pasty-like in con¬ 
sistency and have an acid reaction. 

Paragraph 414 

Now let us consider in a general way the ab¬ 
normal condition of the stool. We often have cases 
where green stools occur and is also often mixed 
with white or yellow curds caused by the casein or 
fat that is contained in the food. We can tell 
whether it is a casein curd or a fat curd by placing 
it in a 10% formalin solution and allowing it to 
stand from six to eight hours. If the curd is due to 


Page One Hundred Sixty-one 





LECTURES OF INTEREST TO WOMEN 


casein it will harden, if it due to fat, it will be¬ 
come soft. 

In chronic indigestion we generally have a 
stool that is quite pasty and clay-like with a foul 
odor. Green stools occur quite often in new-born 
infants and are generally caused by chemical re¬ 
action of the bile-pigment. 

Paragraph 415 

Drugs like bicarbonate of soda given for a 
few days will cause green stools; also small doses 
of calomel and an excess amount of bile will often 
cause very green stools. 

Paragraph 416 

It must be remembered that there are cases, 
and you will see them frequently, in infants under 
three months old, fed exclusively on breast milk, in 
which the stools contain mucus, curds, and are green 
and lumpy, yet such infants thrive, sleep well and 
are apparently healthy. Just why we have such a 
condition not affecting the infant, is difficult to 
determine. When stools are brown or muddy in color, 
it is frequently caused by diet of animal food, that 
is, when children are fed a great deal of broth. 
Drugs may also cause a dark brown stool. Mucus is 
present more or less in all healthy stools. If there 
is a sufficient amount that can be plainly detected 
with the naked eye, we consider it abnormal. All 
intestinal diseases cause more or less mucus. When 
white or light-gray stools occur ,there is lack of 
bile present and such stools are usually very of¬ 
fensive and consist principally of fat. 

Paragraph 417 

When any of the above abnormal conditions of 
the stool exist that affects the baby, the bowels 
should be thoroughly cleaned out by giving milk of 
magnesia or castor oil, irrigating the bowels out 
good once or twice a day with normal salt solution 
and allow no food except a little barley water or 
plain sterile water for twenty-four hours. When 
this does not correct the case, call the attending 
physician, as medical attention at this time will be 
of great value in preventing stomach or bowel 
trouble. 


Page One Hundred Sixty-two 



CARE AND FEEDING OF INFANT 


Paragraph 418 

TREATMENT OF CONSTIPATION: Some babies have 
constipation to a very marked degree, and this will 
be found more frequently in bottle-fed infants than 
in those fed from the breast. This is generally 
caused in bottle-fed infants by the milk being too 
rich in proteids—that is the large amount of curd 
in cow’s milk. Not having a regular time to move the 
bowels will cause constipation. Remember this and 
note the importance of establishing a regular time 
for the infant’s bowels to move. Do this, and they 
will carry it with them through life. Another pre¬ 
disposing cause is, when the child does not have 
enough exercise. In breast-fed babies, constipa¬ 
tion is often due to the mother’s diet being faulty. 

Paragraph 419 

The ideal way to regulate the bowels and cure 
constipation is by giving correct diet. If in a 
young infant, we dilute the feeding one-fifth with 
water and add a little more cream and use a weaker 
feeding formula for a short time, it will often be 
an advantage. For the bottle-fed babies, when pos¬ 
sible, use distilled water instead of plain boiled 
water in making up the food. Let us repeat again, 

‘‘Have a regular time for moving the bowels.’’ Try 
the vaselined finger or soap stick that has already 
been mentioned. The temporary use of the glycerine 
suppositories night and morning, or an injection of 
one or two ounces of warm soapy water may often suf¬ 
fice to remove the accumulation. 

Paragraph 420 

If the stools are large and hard, as often 
found in bottle-fed babies, introduce an ounce of 
sweet oil in the rectum by means of a glass funnel 
and rubber tube, or by any suitable syringe. This 
is often efficacious in removing the hard secretions 
which are formed. The glass funnel and tube can be 
purchased at any drug store. Use a soft rubber 
catheter in connection with the funnel. Both should 
be boiled before using. The open end of the catheter 
should be slipped over the funnel and the other end 
vaselined and passed into the rectum about three 
inches. This should be done very gently so as not to 
cause any irritation. The baby should be lying on 


Page One Hundred Sixty-three 




LECTURES OF INTEREST TO WOMEN 


its back, with its legs and feet elevated. The sweet 
oil should be slightly warmed and slowly poured 
into the funnel. If the oil refuses to run, move the 
tube in and out of the rectum gently, and it will 
soon start. After the oil has run into the rectum, 
gently withdraw the tube and pinch the buttocks to¬ 
gether and hold them for a few minutes so the oil 
cannot escape. From one-half an hour to three hours 
after the treatment, the baby will have a soft stool. 
Sometimes it takes a little longer. 


Paragraph 421 

To give an enema or colon irrigation, lay the 
child in the same position as above mentioned, with 
its feet elevated. Take an ordinary fountain syr¬ 
inge with a long connection tube and use a number 
12a soft rubber catheter. The small catheter is 
connected to the tube from the fountain syringe with 
a small piece of glass tubing, or better still, an 
ordinary eye dropper. Fill the bag with the desired 
solution, unless instructed differently, use a 
normal saline solution, and have it good and warm. 
Vaseline the catheter and insert the tip of it into 
the baby’s rectum. The water is allowed to run from 
the bag and the catheter is slowly pushed into the 
rectum three or four inches. The fountain syringe 
should hang about four feet above the baby’s body. 
Allow any required amount of the solution to run into 
the baby’s bowels. True, the baby’s bowels cannot 
hold this amount of water, nor will it stay. It will 
immediately run out along the side of the rubber 
catheter washing out the contents of the bowels. 
Continue the irrigation until the solution returns 
clear. In young infants use the saline solution only 
half strength. In all cases after irrigating the 
bowels, remove the glass connection, and let all 
the solution run out of the colon before removing 
the catheter. 


Paragraph 422 

Massaging the bowels with your warm hands 
will often assist in relieving constipation. Rub 
the skin over the bowels with the tips of your 
fingers, using a gentle pressure. 


Page One Hundred Sixty-four 




CARE AND FEEDING OF INFANT 


Paragraph 423 

Many mothers resort to various medications 
for the treatment of constipation. The frequent 
use of castor oil is very bad practice. You may give 
one dose of oil when the baby is troubled with colic, 
diarrhoea, and the intestines are filled with un¬ 
digested material, but it should not be given in 
chronic constipation, or given as a general routine. 
The dose of castor oil during the first year is from 
one-half to one teaspoonful. 


Paragraph 424 

Castoria is a great favorite and a very good 
formula. Phillips’ Milk of Magnesia is much better, 
and has a better effect on the stomach and bowels, so 
if you are going to use drugs at all, use Phillips’ 
Milk of Magnesia. It can be put into the milk of a 
bottle-fed baby in any required amount. In con¬ 
stipated babies, use more sugar of milk instead of 
so much lime water. If a baby three months of age is 
taking four or five ounces of milk at a feeding, you 
can add one-half ounce of Phillips’ Milk of Magnesia 
to the 24 hour feeding. Increase or decrease the 
amount as needed. In this way the baby gets a small 
amount of milk of magnesia in every feeding. In 
breast-fed babies ,a few drops of milk of magnesia 
can be added to the water the baby takes from the 
nursing bottle. 


Paragraph 425 

COLIC: Infants for the first three months 
suffer with colic more or less. Especially is this 
true in bottle-fed babies. Colic is the formation 
of gas in the stomach and intestines, without any 
inflammatory condition being present. The reason 
that a baby has colic is probably from two general 
causes: First, the lack of proper muscular tone to 
the intestinal walls; second, errors in diet. 

When the colostrum continues for several 
days, and the milk is not secreted normally, is an¬ 
other cause of colic. Such conditions as women who 
menstruate or become pregnant during the nursing 
period will usually cause colic. 


Page One Hundred Sixty-five 



LECTURES OF INTEREST TO WOMEN 


Paragraph 426 

When an infant has colic it cries out loudly, 
and gives sudden shrieks, due to pain in the abdomen 
caused by distention of gas. Infants asleep will 
often awaken with a sudden start and cry. They will 
flex the legs, and move them back and forth. The 
abdomen is often swollen and hard. Such symptoms 
will continue, and the infant will cry until the gas 
is passed by the mouth or from the bowels, when the 
symptoms suddenly cease. 

Paragraph 427 

Attacks of colic in an infant, you will find, 
are usually associated with constipation; there¬ 
fore, when an infant is suffering with colic, the 
first thing to do is to give an enema,, and see that 
the bowels move freely. Occasionally diarrhoea 
occurs with colic, but it is not the rule. It is well 
for you to remember that the origin of all colic is 
certainly the feeding, so the diet must be carefully 
regulated, and for the bottle-fed infants it will, 
in some cases, be necessary to change or modify the 
milk formula. 

Paragraph 428 

If the stools are thin and greenish, smell 
very acid, and cause a redness of the skin on the 
buttocks, we may say the food contains too much 
sugar. In that case it would be well to stop using 
any sugar (if bottle-fed) , but sweeten the food with 
saccharine tablets, using one grain of saccharine 
for every pint of food. When constipated, add the 
required amount (start with Yz ounce in the twenty- 
four hour feeding) of Phillips’ milk of magnesia to 
the food ,or calcined magnesia, Yz teaspoonful to 
each eight ounces of food. Either will relieve the 
constipation. In these colic cases, if necessary, 
increase the amount of magnesia to obtain the de¬ 
sired results. 

Paragraph 429 

When a baby has colic, and the stools contain 
a great deal of white curds, this condition associ¬ 
ated with constipation is an indication that there 
is too much protein in the food. This often occurs 
where milk is superheated in sterilizing it, or milk 


Page One Hundred Sixty-six 





CARE AND FEEDING OF INFANT 


that is strongly acid in reaction. To increase the 
protein in breast-fed infants, increase the 
mother’s exercise up to the point of fatigue. In 
artificially fed infants, use a weaker formula or 
give the infant a half ounce, more or less, accord¬ 
ing to the infant’s age, of water before each 
feeding. 

These food regulations would be prescribed by 
the attending physician in cases where colic is 
severe. 

Paragraph 430 

TREATMENT OF COLIC: The treatment and cure of 
colic is not so difficult when we know the cause. 
The quickest method to relieve the gas from the 
bowels is to give a saline enema, weak soap enema, 
or an enema of warm chamomile tea. To make the chamo¬ 
mile tea, take an ounce of German chamomile flowers, 
and steep them in a quart of boiling water for fif¬ 
teen minutes ,then strain, and irrigate the rectum 
and colon with a pint or two of the chamomile tea at 
a temperature not over 90 to 100 degrees F. , which is 
about the right temperature for all enemas for 
infants. The infant hot water bag may be applied to 
the abdomen; massaging the abdomen with warm sweet 
oil is also good. Let the hand move very gently 
over the ascending transverse and descending colon. 
That is, follow the direction of the large intest¬ 
ines, starting at the lower righ-hand side of the 
abdomen ,extending the hand up towards the ribs, 
then across the abdomen, and down the opposite side. 

Paragraph 431 

The spice plaster applied to the abdomen will 
often afford much relief from the pain. You will 
make a spice plaster by taking equal parts of 
ginger, cloves, cinnamon and allspice, and placing 
the mixture between a thin flannel cloth, and dampen 
it with hot whiskey, brandy or 40% alcohol. 


Paragraph 432 

Do not recommend or allow your patients to use 
any of the so-called ‘‘Colic Cures” that are for 
sale at the drug stores, because most of them con- 


Page One Hundred Sixty-seven 





LECTURES OF INTEREST TO WOMEN 


tain more or less opiates, which are harmful to 
infants. A soda mint tablet dissolved in a table¬ 
spoonful of warm water may be given to the infant 
every half hour for a few doses during the attack, 
or if preferred, give one teaspoonful every ten 
minutes. 

Paragraph 433 

Remember that during an attack of colic, an 
infant must never be fed. The warm milk, it is true 
(either the breast milk or bottle fed), may stop the 
crying for a few minutes, but it will only increase 
indigestion, and the gas will accumulate and the 
pain return as bad, if not worse, than before. 

Paragraph 434 

Lifting the child up over the shoulder, and 
applying friction by rubbing the back, thus chang¬ 
ing its position, sometimes causes the gas to escape 
by the mouth. 

Paragraph 435 

There is an infant anodyne granule made by the 
Abbott Alkaloidal Co. that is worthy of attention. 
It is made with and without Codine, for young in¬ 
fants; the one without Codine is preferred. You can 
give the one without Codine every 15 to 30 minutes 
until relieved. Give the granule by dissolving it 
in a teaspoonful of warm water. 

Paragraph 436 

In every case of colic, let your first thought 
be to empty the bowels by giving a colon irrigation, 
the same as you have been instructed to give in cases 
of constipation. If the case is so severe, which 
sometimes occurs, and the baby seems exhausted and 
cold, especially the hands and feet, as a result of 
the pain, it should be given three or four drops of 
brandy in a teaspoonful of hot sweetened water, and 
placed at once in a hot bath. 

Paragraph 437 

In infants suffering constantly with recur¬ 
ring colic, the physician should be summoned, be¬ 
cause if you don’t relieve or prevent it by means 
just described, it will be beyond your ability as a 
nurse, or the mother’s, to treat the case without 


Page One Hundred Sixty-eight 




CARE AND FEEDING OF INFANT 


assistance, as it will need special medical at¬ 
tention. 

Paragraph 438 

DIARRHOEA: Some babies have more or less 
diarrhoea, and when it occurs we know it is caused 
generally by the food being contaminated, or some¬ 
thing is wrong with the food or water that the baby 
is taking. Impure milk, too much fat, too much 
sugar, imperfect action of the bile and pancreatic 
juices are all causes of diarrhoea. In the breast¬ 
fed baby it is often caused by the mother having re¬ 
ceived bad news or a nervous shock of any kind. So 
when the baby has diarrhoea, and it continues, it is 
a safe procedure to notify the physician and not rely 
wholly upon your own judgment because a little judi¬ 
cious treatment at the commencement of any form of 
diarrhoea may often avoid a severe illness. It is 
often the beginning of some acute infectious dis¬ 
ease. Diarrhoea occurs more frequently in hot 
climates. The summer diarrhoea, which all mothers 
dread so much, is usually caused by the improper care 
regarding baby’s feeding. Bottle-fed babies are 
much more liable to attacks of diarrhoea than breast 
fed babies. If a baby under your care is suddenly 
taken with diarrhoea, has fever and seems greatly 
depressed, you do this: stop all food; give a dose of 
castor oil, 20 to 30 drops or more to a young infant, 
one teaspoonful or more to a child six months old. 
Give barley water at regular three-hour schedule. 
Baby may have an ounce or so of plain sterile water 
several times a day. Have the physician see the 
case as soon as possible. When you start feeding use 
about one-half the regular amount, and increase a 
little every feeding until the baby is on full diet 
again. Remember that the mildest cases of diarrhoea 
may prove rapidly fatal in the infant. That is why 
we recommend that you use great care not to take too 
much responsibility upon your own shoulders in 
regard to such cases, so let the physician help you. 

Paragraph 439 

WEAUING: Weaning the baby is one of the im¬ 

portant subjects with which you must be familiar, 
because while you may not have charge of the case at 


Page One Hundred Sixty-nine 




LECTURES OF INTEREST TO WOMEN 


this time, you had the mother during her confinement 
and undoubtedly you will be asked a great many ques¬ 
tions concerning the care of the child, and you can¬ 
not know too much about the care and feeding of 
infants. 

When we speak of weaning a nursing infant we 
mean the gradual giving of modified cow’s milk, or 
one of the foods in place of mother’s milk, on which 
it has lived since birth. When we speak of weaning 
a bottle-fed baby we mean that it is to be given other 
foods in addition to modified cow’s milk, such as 
meat broths, vegetable soup, toast, gruels, etc. 


Paragraph 440 

In countries where the summers are hot, it is 
always best to wean babies during spring or fall. 

We cannot give any special time when the baby should 
be weaned, whether it be at this age or that age. 
There are many conditions that might occur in con¬ 
nection with the individual infant that would neces¬ 
sitate weaning it at an earlier or later date. 


Paragraph 441 

Mother’s milk, after nine months, under 
normal conditions, rapidly begins to lose its food 
value, so this is the selected time to begin weaning 
the infant. Under no consideration should the child 
be nursed longer than one year. 

Paragraph 442 

Weaning is more gradual in some cases than in 
others. Excellent results are obtained in a few 
days by the absolute cessation of breast feeding. 


Paragraph 443 

If a nursing mother becomes pregnant, then we 
must wean the baby without question. 


Paragraph 444 

Weaning becomes imperative when a nursing 
infant does not gain in weight, cries a great deal, 
(especially after nursing) has thin, watery stools 
and does not sleep well. 


Page One Hundred Seventy 




PREPARATION OF THE PATIENT 


Paragraph 445 

An infant must be weaned if the mother becomes 
ill with any of the infectious diseases, accompanied 
with fever. 

Weaning an infant from the breast is frequent¬ 
ly a very difficult task, and you must have the co¬ 
operation of the mother in every sense of the word. 
In young infants, two or three months old, you can 
usually substitute a bottle of modified cow’s milk 
for a breast feeding and gradually increase the 
number of bottles of feeding until the child is com¬ 
pletely weaned, but with infants over six months 
of age, to attempt such a procedure is usually with¬ 
out effect. In older infants the best and most suc¬ 
cessful way is the sudden removal from the breast 
and feeding entirely with artificial food. The 
greatest difficulty is to overcome the stubbornness 
with which some children will hold out, but there is 
no grave danger and the attendants must be masters 
of the situation. To make weaning less difficult 
it is always well to accustom the child to the bottle 
early in life when giving it water. 

Paragraph 446 

If for any reason it becomes necessary, by 
order of the physician or otherwise, to wean a nurs¬ 
ing infant between 6 and 9 months of age, take it 
from the breast and start in with a formula one- 
half the regular strength. Thus if an infant is 8 
months old, start with a formula for a 4 months-old 
infant; if 6 months old, start with a 3 months’ 
formula, and so on. Then gradually increase the food 
every two or three days until the correct formula is 
obtained. If under six months old give mixed feed¬ 
ing, using the same rule as mentioned above, only 
wean the infant gradually, that is, you would start 
with one feeding a day of modified cow’s milk and 
give this for two or three days. Then give two arti¬ 
ficial feedings in like manner, and very soon the 
infant would only be nursing once during the 24 
hours, and that would be the last nursing at night. 
Gradually increase the strength of the food until 
you are giving the formula to correspond with the 
child’s age—keeping the gradual increase until the 


Page One Hundred Seventy-one 




LECTURES OF INTEREST TO WOMEN 


ninth month—then begin to add other foods to the 
diet just the same as you would do when you wean the 
infant from the breast at nine months, only you do 
not altogether stop the modified cow’s milk like 
you do in breast feeding. 


Paragraph 447 

When you wean a nursing infant between the age 
of 9 and 12 months, which is the regular and normal 
time, take it from the breast and give it at first a 
modified formula for a six months-old infant or 
Formula No. 5. If this does not cause any stomach or 
bowel trouble, gradually increase the food each day 
until the Formula No. 6 or 7 is reached, accord¬ 
ing to its weight. After the infant is doing well 
for one or two months on Formula No. 7, you can begin 
to give it part of a soft boiled egg once a day, toast 
or Zwieback, also Graham crackers soaked in sweet¬ 
ened water, prune, orange and vegetable juices. 
Water from cooked vegetables, especially spinach, 
carrots, beans and peas. When giving other foods in 
addition to the.modified cow’s milk, you would give 
less of the milk, or better still, miss a regular 
milk feeding and give other foods. You will note the 
weight of the child and the number of calories re¬ 
quired and let this be your key as to the amount of 
food given. 


CARE OF PREMATURE INFANTS. 

Paragraph 448 

Now let us consider the special care required 
for premature infants. Quite often children are 
born before their time and require special care. 

Great nursing skill, great sacrifice and 
devotion on the part of the mother and nurse is re¬ 
quired in order to be successful in such cases, but 
with the proper care, children who are able to nurse, 
breathe and digest food can generally be saved, and 
when grown up, they become strong robust children. 

There is a popular idea among the laity that 
a seven months baby has a better chance for life 


Page One Hundred Seventy-two 




CARE AND FEEDING OF INFANT 


than an eight months. This is not true, because 
the longer an infant remains in the uterus the 
stronger it becomes. Yet it is well to remember 
that if pregnancy goes too far over time the child 
may die. 

Paragraph 449 

All children are premature who are born 
three weeks before the normal end of pregnancy. 
Such premature infants are very small, weighing 2 
to 5 pounds. The blood vessels show through the 
skin, which makes the skin very red. The body is 
covered more or less with a fuzzy growth of very 
fine hair. The ears are very soft and pliable, and 
the infant has a very old looking appearance after 
the loss of weight has occurred, and the little body 
is shriveled. 

Paragraph 450 

The cry of a premature infant is very weak 
and whining. It generally lies in a peculiar 
stupor; the temperature subnormal and very irregu¬ 
lar; bowels sluggish; urine scanty; and generally 
the infant becomes jaundice. The loss of weight is 
greater in proportion than that of children born at 
term, and it requires a great deal more time for 
the premature infant to regain its normal weight, 
requiring some 20 to 30 days. Such infants must be 
forcibly fed, and the collapsed condition of the 
lungs properly relieved, if we expect to be suc¬ 
cessful in our treatment. 

Paragraph 451 

Three important conditions are necessary to 
insure success in saving the premature infant. 
First, it must have mother’s milk; second, it must 
have good nursing; and third, it must be placed in 
an incubator. Heat is absolutely necessary for a 
premature infant and this is obtained by the modern 
incubator. It not only furnishes the proper heat, 
but also insures the infant inadequate fresh air 
supply. Institutions, such as maternity hospitals 
and general hospitals taking obstetrical cases, 
should be equipped with incubators of the modern 
type. Premature infants can be brought from a great 
distance to these institutions where they can re¬ 
ceive the proper care. 


Page One Hundred Seventy-three 


LECTURES OF INTEREST TO WOMEN 


Paragraph 452 

In cases where it is impossible to obtain the 
services of such an institution equipped with an 
incubator, you can make a warm nest for the pre¬ 
mature infant by means of a large clothes basket, 
well lined'with blankets, and apply the heat with 
hot water bottles. The hot water bottles are placed 
around in the folds of the blanket and changed 
frequently, in order to keep an even temperature. 

A soft pillow can be placed in the bottom of the 
basket. With such a makeshift for an incubator, 
and with the proper constant attention, good work 
can be accomplished. 


Paragraph 453 

If the child is very premature, and if its 
temperature remains low, the temperature of the 
water in the hot water bottles must be higher than 
when the child’s temperature is more favorable. 
The basket should be placed in a well ventilated, 
warm room, with an even temperature, and without 
any draughts. 


Paragraph 454 

DRESS FOR PREMATURE INFANTS. The dress 
should be of the finest wool flannel, and made as 
simple as possible. As soon as the premature infant 
is born, it should be wrapped in a soft warm flannel 
or eiderdown wrap and placed in the incubator or 
basket ,and the basket placed in a warm room. The 
best dress is a simple bag about three feet long 
and twenty inches wide at the bottom, stitched 
around the neck, without sleeves. It is open at 
the bottom so that the infant may be changed without 
any trouble, and long enough to double over and 
make a sort of a cover reaching to the shoulders. 

The child is covered with a light wool blan¬ 
ket, which makes a sort of a hood over the head. 

The abdominal binder should be made of wool, and 
the diaper made of cotton material. A warm water 
bag should be laid under its feet in order to keep 
them perfectly warm. See that it is properly pro¬ 
tected so that it will not burn. The child’s feet 
are generally cold, due to poor circulation. 


Page One Hundred Seventy-four 







CARE AND FEEDING OF INFANT 


Paragraph 455 

DIET FOR THE PREMATURE INFANT. Mother’s milk 
is the correct diet for premature infants, and must 
be obtained at any expense of money or effort. The 
infant must be fed immediately after birth to avoid 
exhaustion, and to combat the great initial weight 
loss. For the smallest infants, give 5 to 20 drops 
of two-thirds mother’s milk and one-third water 
every thirty minutes with a medicine dropper. If 
the child retains this, increase the amount to 30 
or 40 drops. After twenty-four hours, the intervals 
are lengthened to an hour. 


Paragraph 456 

The following is the diet list as given by 
Dr. DeLee of Chicago in ‘‘The Care of Premature 
Infants’’: 


FOR INFANTS 

Total Quantity. 

1st day, every 
2nd day, every 
3rd day, every 
4th day, every 
5th day, every 
6th day, every 
7th day, every 


WEIGHING LESS THAN THREE POUNDS (3 lbs.) 

v Every Hour. 

thirty minutes, 15 drops: water 1 part, milk 2 parts; 


hour, 30 drops: water 1 part, milk 2 parts; 

hour, 40 drops: water 1 part, milk 2 parts; 

iy 2 hours, 1 drain: water 1 part, milk 2 parts; 

iy 2 hours, 1 dram: Pure mother’s milk; 

2 hours, lt/2 drams: Pure mother’s milk; 

2 hours, iy 2 drams: Pure mother’s milk. 


FOR INFANTS WEIGHING LESS THAN 3 lbs. 12 oz. 


Total Quantity. Every Hour. 

1st day 63 grams (2 oz. y 2 dr.).. 45 drops 

2nd day 127 grams (4 oz. 1 dr.). 75 

3rd day 151 grams (5 oz.). IV2 drams 

4th day 200 grams (6y 2 oz.). 2 

5th day 224 grams (7 oz. 2 dr.).. 2 “ 15 m 

6th day 230 grams (7 oz. 4 dr.). 2y 2 “ 

7th day 263 grams (8^2 oz.). ...-. 2 “ 45m 

8th day 281 grams (9 oz.). 3 

9th day 303 grams (10 oz.)... 3 y 2 “ 

FOR INFANTS WEIGHING FROM 3 lbs. 12 oz. TO 4 lbs. 9 oz. 

Total Quantity. Every Hour. 

1st day 120 grams (4 oz.). 75 drops 

2nd day 173 grams {5y 2 oz.)._. 2*4 drams 

3rd day 247 grams (8 oz.).-. 2*4 “ 

4th day 281 grams (9 oz.).... 3 

5th day 312 grams (10 oz.). 3^4 “ 

6th day 347 grams (11 oz. 2 drams). 3% 

7th day 364 grams (11 oz. 7 drams). 4 

8th day 393 grams (12 oz. 5 drams). 4 1 /4 “ 

9th day 404 grams (13 oz.). 4 y 2 “ 


Page One Hundred Seventy-five 





















LECTURES OF INTEREST TO WOMEN 


FOR INFANTS WEIGHING FROM 4 lbs. 9 oz. TO 5 lbs. 4 oz. 


Total Quantity. 

1st day 153 grams (5 oz.). 

2nd day 266 grams (8 oz. 5 drams).. 

# 3rd day 299 grams (10 oz.). 

4th day 341 grams (11 oz.). 

5th day 365 grams (11 oz. 7 drams) 
6th day 390 grams (12 oz. 5 drams) 

7th day 400 grams (13 oz.)... 

8th day 413 grams (13 oz. 3 drams) 
9th day 418 grams (13 oz. 4 drams) 


Every Hour. 

l 1 /^ drams 
3 

3 y 2 “ 

31/4 “ 

4 

41/4 “ 

4V 2 “ 

4% “ 

f; “ 


This diet list can be increased or decreased 
as the case may require. Judgment must be used as 
to the amount of food an older child should have— 
that is, a small older child, that is premature, 
would require more food than a larger young pre¬ 
mature child. A general rule to go by is to give the 
child all that it can be induced to swallow, yet 
care must be taken not to over-feed. On the other 
hand, you must have^ sufficient nourishment in order 
to overcome the depressed condition. Feeding must 
be carefully and consistently practiced. The child 
should be laid on its right side after each feeding 
and must not be left alone, but must be kept under 
constant observation. 


Paragraph 457 

When an infant is not getting enough food, and 
loses weight, it will have a tendency to lie in a 
peculiar stupor, have attacks of fainting, some¬ 
times with marked cyanosis. The amount of food 
should be carefully measured. The infant must be 
weighed on delicate scales to ascertain its loss or 
gain. The total amount of food taken by the infant 
in twenty-four hours should be equivalent to one- 
fifth of the child’s weight. Therefore, a pre¬ 
mature infant weighing 3 pounds should be given 
9 ounces of milk per day. 


Paragraph 458 

METHOD OF FEEDING PREMATURE INFANTS. If the 
premature infant can nurse (suck the nipple) and 
swallow, the milk is given by means of a small vial 
and tiny nipple. If the child can swallow but not 
nurse the nipple, the milk is poured into the throat 


Page One Hundred Seventy-six 












CARE AND FEEDING OF INFANT 


with a feeding-dropper. All utensils, such as 
breast-pump, bottle, dropper and nipples, must be 
thoroughly sterilized before using. 

Paragraph 459 

If the child can neither nurse nor swallow, 
it must be fed by means of the stomach-tube, which 
is attached to a small glass funnel. The stomach- 
tube used is a small rubber catheter, size No. 8 
American for the small infant, and No. 10 for the 
larger ones. The mother’s milk, is obtained by 
using the breast-pump. It is properly diluted and 
warmed. The infant is placed on the lap, with face 
upwards and a little to one side. The tube is filled 
with milk, clamped with the fingers, passed into 
the throat, and quickly into the stomach. A depth 
of four inches is usually sufficient. Then the 
measured quantity of milk is slowly poured in, 
taking care that air is not permitted to enter. 
Withdraw the tube with rather a quick motion, and 
the child is held quiet for a few moments, after 
which it is carefully placed in the basket or in¬ 
cubator, and carefully watched for a few minutes to 
see that the milk does not regurgitate and strangle 
the infant. 


Paragraph 460 

Over-feeding is more apt to occur when the 
stomach-tube is used than any other way. Great care 
must be taken that no abdominal distention, vomiting 
or indigestion occurs. Premature infants must be 
supplied with sufficient water. As soon as the 
premature infant is able to nurse, it should be put 
to the breast, as DeLee says: 4 ‘Nothing can match 
the life-giving fountain.’’ 


Paragraph 461 

BATH FOR PREMATURE INFANTS. Handle premature 
infants as little as possible. As soon as the pre¬ 
mature child is born, it is covered warmly, and 
taken to a hot room, and the whole body is anointed 
with warm sterile benzoinated lard. This is care¬ 
fully and quickly wiped off with a hot towel, and 
further dressing is to be avoided if the infant is 
very weak. 


Page One Hundred Seventy-seven 





LECTURES OF INTEREST TO WOMEN 


Paragraph 462 

It must first remain several hours in the 
incubator or basket until it has recovered from 
shock. For the first week, the whole body is 
anointed daily with the finest sterile benzoinated 
lard. The face and buttocks are occasionally 
washed with warm water. Stronger infants are gent¬ 
ly immersed into water at a temperature of 103 
degrees F. for a few seconds—not over thirty—then 
place it on a warm towel for drying. After this the 
body is anointed with benzoinated lard. The regu¬ 
lar bath, as usually given to infants, is postponed 
until the child is quite vigorous. 

Paragraph 463 

CARE OF THE EYES OF PREMATURE INFANTS. The 
eyes are given very little, if any, attention, 
except ordinary care. Great care must be taken not 
to injure or abrade the mucous membranes, as the 
infant is very susceptible to infection. 

Paragraph 46£ 

CARE OF THE MOUTH. If the tongue is coated, 
wash the mouth out daily with a very weak boric- 
acid solution, but this is not needed if the tongue 
is clean. Great care should be taken not to injure 
the tender mucous membrane. 

Paragraph 465 

CARE OF THE NOSE AND EARS. The nose and ears 
should not receive any treatment, only what would 
be considered necessary cleanliness. Be careful 
not to injure the skin or mucous membranes about the 
nose and ears by any undue manipulation. 

Paragraph 466 

CARE OF THE CORD. Care of the cord in pre¬ 
mature infants is of great importance on account of 
preventing any infection, and it must be kept per¬ 
fectly dry and sterile. Dry gangrene is the favor¬ 
able way for separation to take place. 

Paragraph 467 

CARE OF THE GENITALIA. Great care must be 
taken in the care of the genitalia in both boys and 
girls. In girls, the parts must be handled with 


Page One Hundred Seventy-eight 



CARE AND FEEDING OF INFANT 


extreme delicacy and with antiseptic precaution, 
in order that the parts do not become infected. In 
boys, the napkin should be applied loosely to avoid 
any compression. The buttocks is very tender, and 
the skin becomes inflamed with the slightest irri¬ 
tation. The parts must be kept scrupulously clean, 
and the napkin must be changed immediately after 
urinating or bowel movements. 

This is very important in order to prevent 
the skin from becoming irritated and infected, and 
if the skin should become irritated it should be 
thoroughly dried and quickly changed with the 
smallest amount of exposure possible. The parts 
are dried by laying a soft cloth on the skin, and 
the fingers are rubbed over it; then stearate of 
zinc powder is applied to the affected parts. let 
us mention the fact: Never use boric-acid in such 
cases because it will irritate the skin. In place 
of the stearate of zinc powder, rice powder that is 
very fine is also good. 

Paragraph 468 

DAILY CARE. Every day the infant is anointed 
with sterile benzoinated lard, and it is given a 
general massage. Rub the skin very gently, kneading 
the muscles of the arms and legs, and bend the 
joints. This is done with the most extreme gentle 
care, and when the child is very weak such treatment 
should be given only every other day. This massage 
treatment must be employed in order to overcome the 
torpid state present in premature infants, and 
cause the blood to circulate more freely in the 
extremities and lungs. For the same reason, a child 
should lie first on one side and then on the other. 
Take the temperature morning and evening per rectum, 
and more frequently if there is fever. 

The infant should be weighed every other day 
during the time that the benzoinated lard is being 
applied, and it should be weighed naked on delicate 
scales. Great care should be taken that the baby 
does not get chilled. Weigh it in a warm soft blan¬ 
ket that is free from irritation, or a napkin can 
be used. Both blanket and napkin should be very 
warm. 


Page One Hundred Seventy-nine 



LECTURES OF INTEREST TO WOMEN 


Paragraph 469 

The diseased conditions that exist in pre¬ 
mature babies are the same as new born infants af 
term, only more severe, and infection, possibly, 
is the cause of more deaths than any other one thing 
in these little mites of humanity. The infection 
comes through the nasal passages, the mouth, or 
from the separation of the cord. Infection of the 
lungs in the form of pneumonia or bronchitis are 
very common, and both are very difficult to diagnose. 

The gastro-intestinal tract often becomes 
infected. In that case, the symptoms of gastro¬ 
intestinal trouble are present—like diarrhea, 
green irritating stools with offensive odor, fever 
and vomiting. The digestive tract may become in¬ 
fected through the mouth, impure air, improper 
food, or from the lack of proper sterilization of 
bottles, nipples, etc., and the attendants who are 
careless in regard to asepsis will do much harm. 

Paragraph 470 

Simple indigestion often occurs, which is 
manifested by vomiting, loose stools with curds, 
with additional loss of weight. In such cases, be 
sure the infant is not over-fed. The milk must be 
properly diluted and small feedings given several 
times at regular intervals. Note if the stomach 
will retain it. DeLee says the addition of ‘‘Peptic 
Salt’’ to the milk will often correct this condi¬ 
tion. Peptic salt is made by mixing 1 part of the 
finest table salt with 9 parts of the best scale 
pepsin —Yi grain is given with each feeding. 

Paragraph 471 

THRUSH. In premature infants, a sore mouth 
with white spots formed on it is more common than in 
full term infants; therefore, to prevent thrush, 
the demand for absolute cleanliness is imperative. 
In treating thrush, after each feeding the mouth 
should be washed with a saturated solution of borax, 
and this should be done with the greatest care not 
to injure the delicate mucous membrane. This can 
be done with a sterile cotton applicator. The sur¬ 
face should be gone over gently, removing all loose 
material. The spots may be touched daily with 2 per 


Page One Hundred. Eighty 





CARE AND FEEDING OF INFANT 


cent Nitrate of Silver solution, and after applying 
the silver solution, a drop or two of castor oil put 
in the mouth will allay the irritation. 

Paragraph 472 

BLUE SPELLS. Premature infants often become 
cyanosis, and they turn blue, cease to breathe, and 
often die unless given immediate relief. Such con¬ 
ditions are very difficult to treaty because the 
infant is very weak and not able to keep up the 
efforts of respiration. A dip in a hot bath, 
artificial respiration and stimulation with a drop 
of whiskey diluted with a few drops of sterile water 
may help the little creature to regain its color 
and successfully relieve the attack. The cause of 
these blue spells is exhaustion or anything that 
interferes with the heart’s action, like improper 
feeding. 

Paragraph 473 

If the infant is choking, it should be held 
up by the legs and obstructions removed from the 
throat, and if this does not succeed, the same method 
can be employed by squeezing the chest from before 
backwards, the same as resuscitating asphyxiated 
babies, as already explained in the management of 
the second stage of labor. 

Paragraph 474 

The lungs are often in a condition known as 
atelectasis pulmonum, which means the lungs of the 
child have not unfolded and the air cannot enter the 
lungs. In these cases the child generally dies from 
asphyxia. In such cases the child retains a blue 
color, the same as blue babies that are born with 
some heart disease. Unless the child cries, and 
the healthy pink color of the skin is obtained, it 
will almost invariably die. Treatment of such a 
condition is to get the baby to cry. 

In conclusion, let us say that if you are suc¬ 
cessful in saving these premature babies, have no 
fear but what they will grow up to be vigorous and 
strong men and women; therefore, every effort 
should be made to save them. 


Page One Hundred Eighty-one 
























' 
































































PART III 


Contains a complete discussion 
about conditions that are caused 
by the various diseases common in 
children, together with nursing 
treatment; including diet list, 
formulas, and other practical 
knowledge about the training of 
infants and children. 








































































































































































































































































































DISEASES OF CHILDREN 


Before taking up in detail the subject of 
special diseases of children, let us consider the 
management of a sick child in a general way. 

It is not our aim to try to teach the mother 
or nurse to become a physician, but it is our inten¬ 
tion to instruct them and to give them such knowl¬ 
edge that they can intelligently care for and treat 
all the common ailments of children, and be able to 
successfully nurse serious cases. 

If the child is sick, the mother or nurse 
should have a suffcient knowledge as to the nature 
of its ailment to know when to send for a physician, 
what to do before he arrives, and to carry out his 
instructions in an intelligent way. Our aim is to 
teach these facts. 

We will give conditions that exist in the 
child, caused by disease, in a way that will be of 
most value. Let us begin by teaching how to tell 
when the child is sick. 


Paragraph 476 

1. The position of a sick child is important. 
Oftentimes at the beginning of an acute disease, 
the child lies very quiet and in a stupor. When 
a child wants to sit up, or to be propped up with 
pillows, or if it wants to be carried in a position 
with the head and shoulders forward, it is an in¬ 
dication of difficult breathing, which means some 
trouble with the throat, heart, or lungs. 


Page Hundred Eighty-five 



LECTURES OF INTEREST TO WOMEN 


Paragraph 477 

2. When a child is perfectly still, assumes 
one position, and cries when it is moved, tells you 
that the child is still because the parts become 
painful in changing position, which might indicate 
rickets or some inflammatory condition. When 
children sleep with the mouth open and the head 
thrown back, it is an indication of difficult breath¬ 
ing, due to enlarged tonsils or adenoid growths. 

Paragraph 478 

3. When any brain trouble is present, the 
head is generally drawn far back and held firmly in 
that position. Young infants have a tendency to 
place the hands near the seat of pain; thus if they 
have an earache the hand is placed to the ear; if the 
mouth is sore they put the fingers in the mouth; 
if it is a headache they put the hand to the head. 

It must be remembered, however, that the 
movements of a child’s hands are misleading unless 
verified by the physician’s examination and state¬ 
ment, because a hungry child might put its fingers 
in its mouth and there will be nothing the matter 
with the mouth. Before a child has convulsions, 
the thumbs are generally drawn tightly into the 
palms of the hands, and the toes are straightened 
or stiffly bent, and remember the soft spot on 
the head generally bulges in place of being 
below or on a level with the bones. The condition 
that occurs in colic, the movements of the child, 
etc., is fully explained in that subject. 

Paragraph 479 

4. The color of the skin often changes when 
there is any diseased condition present—as in 
jaundice it becomes yellow, and the whites of the 
eyes are also yellow. Remember we mentioned that 
in young infants the skin may become yellow but it 
is not a case of jaundice unless the whites of the 
eyes are also yellow. When an infant is born 
with heart disease the skin often becomes bluish 

in color, especially the face. 

Paragraph 480 

5. Pale circles around the mouth generally 
accompany nausea and stomach troubles. Many 


Page One Hundred Eighty-six 





DISEASES D? CHILDPE'v 



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LECTURES OF INTEREST TO WOMEN 


cases of pneumonia. Breathing is very slow in 
diseases of the brain. Breathing through the 
mouth tells us there is some obstruction in the 
air passages of the nose. 


Paragraph 485 

10. The pulse rate in infants is of very 
little value, and it varies so that it is rarely 
considered. A temperature in a child indicates 
that there is some infection or disturbance of 
some sort—yet remember this fact; that in infancy 
and childhood very little irritation or inflamma¬ 
tion will produce temperature as high as 103 or 
more. Unless the temperature is over 100, we 
generally consider that the child has no fever, 
and it is only moderate from 102 to 103. The high 
temperature is from 104 to 105, and dangerous tem¬ 
perature is above 105. A dangerous temperature is 
one that continues for some time. A child might 
have an acute attack of indigestion, and bowels 
become constipated, which will produce a high tem¬ 
perature very quickly, and as soon as the bowels move 
the temperature disappears. The temperature is 
generally lower in the morning and higher in the 
afternoon and evening. A sudden fall in temperature 
with children is generally a favorable condition— 
especially is this true when accompanied by an im¬ 
provement of the other symptoms, but when there is 
a sudden fall in temperature and the condition of 
the child remains the same, it is very unfavorable. 
We will mention the temperature conditions in detail 
when discussing the different diseases peculiar to 
children. 

Remember that when there is an increase in 
temperature, there is also an increase in the pulse 
rate and breathing. The increase is not as marked 
in children as it is in adults. We can generally 
add about eight or ten beats of the pulse and two or 
three respirations for each degree of temperature. 
Some diseases affect the ratio of temperature, pulse 
and breathing in a special manner—especially is 
this true in diseases like pneumonia. There are 
conditions where we have a subnormal temperature— 
that is, where the temperature is below normal. This 


Page One Hundred Eighty-eight 







DISEASES OF CHILDREN 


condition exists when there is great exhaustion 
caused by a hemorrhage or severe diarrhea. We often 
find a low or subnormal temperature in children who 
are suffering from insufficient nutrition. In some 
cases it remains below normal for several days, and 
yei: it does not terminate fatally. 

Paragraph 486 

11. The tongue of the new-born infant is white 
and generally remains in this condition until there 
is plenty of saliva secreted. The tongue is gener¬ 
ally slightly coated when there is any acute dis¬ 
ease, but it is not as important in children as it is 
in adults. 

Paragraph 487 

12. Grinding of the teeth in older children 
generally tells us that there is some irritation of 
the nervous system or some disturbance of digestion. 
It does not occur, as often is believed, when a 
child has worms. 

Paragraph 488 

13. The manner of nursing and swallowing is 
of some importance in diseases, because when there 
is an obstruction in breathing it must let go of the 
nipple in order to get its breath. Sometimes when 
the baby nurses for a few minutes, and then stops 
and cries, it is due to a sore mouth, and the nursing 
is painful. When an infant has a sore throat it 
generally swallows with a gurgling noise, sometimes 
stops to cough, and will only nurse a little at a 
time. When a baby is sick and. ceases to nurse, it 
is a symptom of great weakness, and is not a favor¬ 
able condition. 

Paragraph 489 

14. Highly colored urine in a child or in¬ 
fant, or urine that stains a diaper; urine that be¬ 
comes reddish after standing; or milky when first 
passed, are conditions that go with fevers and in¬ 
digestion. Sometimes it stains the napkin yellow; 
in that case, as a general rule, the child is not 
taking enough water. We also have a yellow stain 
on the napkin when jaundice is present. A mother 
should also remember that over-feeding with too 
much beef juice or highly nitrogenous foods will 
produce a reddish condition of the urine. 


Page One Hundred Eighty-nine 




LECTURES OF INTEREST TO WOMEN 


Paragraph 490 

15. The condition of the stools, both in 
health and disease, have been fully discussed under 
that heading in Part II., and does not need to be 
repeated. The baby’s cry relative to sickness has 
also been fully discussed in that subject. 

Paragraph 491 

16. One difficult thing in the care of chil¬ 
dren is to give medicine and food according to the 
physician’s instructions. If the child has been 
trained according to instructions given elsewhere 
in these lectures, and it has learned the law of 
obedience, the mother will have less trouble in ad¬ 
ministering such remedies and giving such food as 
may be required. When a child has not had the proper 
training, the nurse or mother is oftentimes com¬ 
pelled to resort to bribery in order to get the child 
to take medicine or food—-promising this or that if 
they will do so and so. During sickness is no time 
to train children, and if a child is disobedient, 
lose no time with arguments, but wrap the child in a 
blanket that fits tightly around the body, includ¬ 
ing the arms to prevent interference, and give the 
child what is necessary for it to have. This is done 
by inserting the spoon in the mouth when it opens it 
to breathe. Empty the spoon and withdraw it slowly. 
Do not leave the spoon in the mouth any longer than 
necessary, as it prevents the child from swallowing. 
Let the mother or nurse give the medicine in this 
manner a few times without excitement or anger on 
her part, and the infant or child will soon learn 
that it must take its medicine. In cases of young 
infants, give only a small amount at a time, as they 
have a tendency to spit out a greater part of it when 
a teaspoonful is given. If the spoon is only half 
full there is much less danger of spilling it, and 
it can be given with greater ease. 

When children fight so hard that exhaustion 
follows, then the question arises—‘‘Does the giving 
of medicine do more harm than the medicine does 
good?’’ This must be decided by the attending phys¬ 
ician. In giving children medicine, let the truth 
be stated at all times—that is, never tell a child 


Page One Hundred Ninety 



DISEASES OF CHILDREN 


that a medicine tastes good when it does not. It is 
a good idea, when giving medicine, to prepare it 
where the child cannot see you, as it does not become 
irritable with the thoughts of taking the medicine 
until it is ready to be given. 

When children and infants are not able to 
swallow large quantities of medicine, or for those 
that lie in a stupid condition, the medicine may be 
administered with a medicine dropper in place of 
giving it with a spoon, and this time the medicine is 
inserted beside the teeth, and the contents will 
generally be swallowed. The medicine dropper should 
have a blunt end, and never place it between the 
teeth, because a child may bite it, and broken glass 
in the mouth would be a very unpleasant condition. 

When giving medicines that have a disagree¬ 
able taste, as most of them do, give a sip of milk or 
water, a little piece of candy, or a bite of an orange 
before and after taking the medicine, and this will 
help to eliminate the bad taste. Oftentimes the 
medicine can be diluted with a little water, and add 
a little sugar. This will help to'disguise the taste 
to a certain extent. Too much water should not be 
added, as it makes the dose to be given too large and 
more difficult to administer. Under 4 ‘Medicines 
for Children,’’ you will note the special instruc¬ 
tions in giving certain kinds of medicine. 

Paragraph 492 

17. It must be remembered that young children 
cannot take pills. When a child is old enough to 
take a pill or tablet, it will be easier to take if 
it is placed in a little jelly or preserved fruit. 

It is a good practice if the mother will play doctor 
with her children, and make little pills out of 
bread, place them in a little jelly, and teach the 
child to swallow them. 

Paragraph 493 

18. Also teach a child to have its throat ex¬ 
amined by taking a spoon and have it open its mouth, 
press down the tongue and examine the throat, and 
in this way a child can soon be taught to have its 
throat examined without any resistance. Also ex¬ 
amine the nose and ears, and if the child is taken 

Page One Hundred Ninety-one 



LECTURES OF INTEREST TO WOMEN 


sick it can then be examined and treated by a physi¬ 
cian with very little, if any, difficulty. 

Paragraph 494 

19. Every mother should be supplied*-with a 
one or two-ounce graduate that will give the right 
measurements, and all medicine should be measured 
correctly. Spoons vary so in size that they are un¬ 
reliable. The proper dosage and the time of giving 
the medicine should receive the mother’s attention, 
because the frequency and dose to be given, of any 
medicine, can only be determined by the physician. 

Paragraph 495 

20. Not only is it necessary to administer 
medicine to sick children, but they also require 
nourishment, and the feeding of a sick child is often 
as important, if not more so, than the giving of 
medicine, and you will find in many cases it is just 
as difficult. The way to quench a child’s thirst, 
or give it nourishment, is to have only a small 
amount in a small glass, and it will probably take 
it all. If you approach a sick child with a full 
glass of milk, the chances are it will take very 
little. 

When there is little desire for food, milk 
may be administered when a child calls for a drink 
of water, and a little sugar or vanilla may be added. 
A little salt may be added to boiled milk. All these 
help to make it more tasteful. Never discuss before 
a child about its food, but fix up what you want it 
to have and administer it at certain times in given 
amounts. 

Paragraph 496 

21. There are three very good rules to remem¬ 
ber when feeding sick children: First, never give 
any new foods, or experiment, you might say, with 
foods when a child is suffering with diseases of the 
stomach or bowels; second, at the beginning of any 
illness give little or no nourishment; third, when 
any vomiting occurs, stop all feeding until the 
physician is consulted. The formula for the propor¬ 
tion of different foods, as given under that head¬ 
ing, will be found very useful in administering food 
to sick children. 


Page One Hundred Ninety-two 






DISEASES OF CHILDREN 


Paragraph 497 

22. A few years ago it was generally believed 
th&t a sick child should not have very much water. 
We remember in the treatment of measles, we were not 
allowed water at all, but today we allow children to 
have all the pure water they want, providing it does 
not interfere with the taking of nourishment. If 
there is any special reason given by the physician 
why a child should not have all it wants, then give 
it very little in a small glass and it will be satis¬ 
fied. 

Paragraph 498 

23. When a child is sick, there is one thing 
that mothers, nurses, visitors, and members of the 
family do not consider as seriously as they should, 
and that is the elimination of noise. Everything 
should be quiet around a sick child, because infants 
and children are not old enough to make this request, 
and they do not realize that their nervousness and 
headaches are due to this unnecessary loud talking, 
heavy walking, shifting of the furniture, or the 
playing of other children. 

Paragraph 499 

24. The little patient should be placed in a 
position that is most comfortable and encouraged to 
remain in that position. A child who has lung 
trouble should never be raised up rapidly. In fact, 
when there are any movements of a sick child of any 
kind, they should be very slow and gentle. Some 
diseases require that the child’s position be 
changed quite often, and it should not be allowed 
to lie in one position too long, in any lingering 
sickness, on account of the formation of bed-sores. 

Paragraph 500 

25. We wish to warn mothers and nurses about 
keeping children too warm when they have fever or 
during the hot weather. The covering should be 
light under such conditions, and when a child is old 
enough it should be consulted as to whether it is 
too warm. An infant with a fever should be kept in 
its crib as much as possible; especially is this true 
in hot weather, as it only aggravates the case when 
it is held on the lap of the mother or nurse. 


Page One Hundred Ninety-three 





LECTURES OF INTEREST TO WOMEN 


When an infant or child is taken up, it is 
wrapped in a blanket. We should not forget to have 
the chest and arms protected during sickness, or' 
when a child is getting well and sitting up in bed. 
It is well to have clothing suitable for the night 
and another outfit for the day that protects the 
chest and arms as well as other parts of the body. 


Paragraph 501 

26. Cleanliness in a case of sickness with 
children is very necessary, and a child should be 
sponged all over at least once, if not twice, a day 
with soap and water or alcohol and water. A warm 
tub-bath may be used in many diseases, but in 
eruptive- fevers, mothers should only give sponge 
baths. Children that have eczema should not be 
washed or sponged off with water, and it is well in 
all cases of sickness to get directions from the 
physician as to the time, kind, and temperature 
that the bath should be given. The bed linen should 
be changed often, and should be warmed in cold 
weather if necessary. When opportunity affords, it 
is well to have two beds— : one for day and one for 
night. This is distinctly restful to the little 
patient and gives it great comfort. The mouth 
should be properly cleansed with a good mouth wash 
like weak solution of listerine or glycothymoline. 

There is no case of sickness but what there 
should be ventilation and plenty of fresh air. Var¬ 
ious applications like dry heat, mustard plaster, or 
turpentine stupes, that are ordered by the physi¬ 
cian, are applied according to directions given on 
another page. Care must be taken in applying hot 
water bottles—see that the skin is well protected. 


Paragraph 502 

27. In some fever cases the ice-bag is applied 
to the head, and may be used sometimes, under the 
physician’s directions, for the relief of pain. In 
purchasing an ice-bag be sure that the rubber is very 
thin and pliable. The bag should not be more than 
half full with small pieces of ice. If the ice-bag 
is not too full of ice, it can be applied to the parts 


Page One Hundred Ninety-four 




DISEASES OF CHILDREN 


quite accurately. As a general rule, children and 
infants do not tolerate cold applications, and we do 
not think it is used very extensively on them, other 
than applying the ice-bag to the head in a case where 
the child has high fever. 

Paragraph 503 

28. The care and flushing of the bowels have 
been thoroughly discussed under ‘‘Colon Irriga¬ 
tion’ ’ . The diet for sick children had better be or¬ 
dered by the attending physician. Remember the 
three maxims we gave you in regard to feeding a sick 
child. 


Paragraph 504 

29. It is very important that the nurse and 
mother be fully impressed as regards the proper 
preparation of food for sick children. A physician 
should give definite instructions as to how much 
food, its form, and how often it should be given. 

It should be written out in detail by the attending 
physician. Its preparation should be carefully 
attended to by the nurse or mother, and it is a good 
practice to keep a record of the food—that is, the 
amount taken, the kind, and frequency, as well as to 
keep a record of the medicines given. Care should 
be taken that neither too much or too little be 
given. It is very easy to err with either extreme. 
In older children, to a certain extent, the child’s 
wishes can be satisfied. The physician would obtain 
from the nurse or mother the child’s likes and dis¬ 
likes. The nurse or mother that is tactful along 
these lines is of inestimable value in preparing and 
giving nourishment to a sick child. A careless or 
stupid mother or nurse in this respect is a source 
of danger. 

Paragraph 505 

30. Nurses and mothers should be trained 
along the line of practical dietetics, and should 
learn how much food is required, the kind to give, 
and also the time to give nourishment in the differ¬ 
ent diseases and types of patients. When food is 
required it should be given at regular intervals, 
whether the patient is conscious, unconscious, or 
semiconscious. 


Page One Hundred Ninety-five 






LECTURES OF INTEREST TO WOMEN 


Paragraph 506 

31. Convalescing patients, especially chil¬ 
dren, often require a great deal of tact in fostering 
the appetite. Such children are generally very 
fastidious when weakened by disease’. The manner in 
which food is prepared and served has a great deal to 
do with the patient’s appetite; especially is this 
true with adults. But even with children, the sick 
room should be orderly, and allow no food in the 
room either before or after serving a meal. Neither 
should dishes or utensils remain, and all food and 
drink should be served from scrupulously clean 
dishes and glasses. Have everything dainty and at¬ 
tractive in appearance. Any dishes that can be gar¬ 
nished with some sort of green sprig should not be 
omitted. Linen and napkins should be perfectly 
clean, in fact spotless, and the outside of glasses 
and cups containing food should be wiped perfectly 
dry before given to patients. 

Paragraph 507 

32. All foods should be fresh and freshly pre¬ 
pared. Food that is allowed to stand until it gets 
stale, like some of the drinks (eggnog for instance) 
then given to a patient, will often have a tendency 
to forever turn a patient against such a form of 
nourishment. Food should not be prepared in the 
presence of a patient. The nurse or mother should be 
satisfied that it is properly seasoned and prepared. 
Food may be tasted, but not in the presence of the 
patient (nor should the same spoon be used by the 
patient) , to determine if it is alright. If anything 
wrong is discovered, it can be remedied before it is 
given to the patient. 

Paragraph 508 

33. The position of the patient while taking 
nourishment should be as comfortable as possible, 
and one in which they will not tire before the meal 
is over. This is as important as the proper selec¬ 
tion, preparation, and administration of the food, 
because the patient is weak, and all food should be 
given in such a form that a patient may take enough 
without becoming overly tired. Children that are 
able to sit up, may be provided with a tray on which 
to place the food. 


Page One Hundred Ninety-six 



DISEASES OF CHILDREN 


Paragraph 509 

34. Sick children should be watched careful¬ 
ly while taking nourishment. Have the food well 
masticated; see that each mouthful is swallowed be¬ 
fore another is given. When patients are asleep, 
especially at night, to waken a child for nourish¬ 
ment requires special judgment. Some children are 
more in need of sleep than food. This should be de¬ 
cided by the physician in charge. If a child does 
not go to sleep quickly after taking food, it may be 
a better plan to wait until it weakens before feed¬ 
ing it. If the child is seriously ill, it is gener¬ 
ally disturbed only a few minutes by taking food. 

In fact, the giving of warm liquid food may often 
induce sleep. 

Paragraph 510 

35. It is very essential that the child’s 
mouth be kept perfectly clean, and it is a good plan 
to wash the mouth before and after taking food. 

When the mouth, is dry, it should be moistened from 
time to time. A little glycerine, water, and lemon 
juice will be found very good. Sometimes patients 
are helpless, and then the mouth should be cleansed 
with a cotton swab on a wooden applicator, or the 
cotton may be wrapped around the finger. The cotton 
should be saturated with some antiseptic solution 
like boracic acid, which makes an efficient mouth 
wash. Abbott’s Menthol Compound tablets (one dis¬ 
solved in a half a glass of water) is an excellent 
mouth wash in cases of fever, tuberculosis, etc. 

Paragraph 511 

36. In cases of infectious fevers, and dis¬ 
eases that are contagious and communicable, a cov¬ 
ered boiler should be used to disinfect all dishes 
and utensils used, and the dishes should be boiled 
in bicarbonate of soda solution, allowing them to 
boil a half an hour. Great care should be taken 
with dishes, towels, etc., that the disease is not 
transmitted to healthy children. 

Paragraph 512 

37. When possible, it is very convenient to 
have a diet kitchen temporarily arranged close to 
the patient’s room, especially in private homes. 


Page One Hundred Ninety-seven 





I 


LECTURES OF INTEREST TO WOMEN 


This is very convenient, and assists greatly in the 
preparation of food for sick children. 

At this time, in connection with the above 
remarks, it would be proper to consider the 
various diseases most common in childhood.' We will 
discuss them in a general way, including the nursing 
treatment with more or less detail, which will be of 
great value to the mother or nurse in caring for 
children that may have any of the acute infectious 
diseases, as well as other ailments, habits, and 
conditions that occur in childhood. 

SCARLET FEVER. 

Paragraph 513 

Scarlet fever is an acute infectious disease. 
It is a specific infection and is very contagious. 
It is one of the most dangerous of any of the acute 
infectious diseases of childhood, on account of 
being associated with so many severe complications. 
It is communicated by direct exposure, by a third 
person, or personal contact in the way of food, 
clothing, toys and books. The disease is not trans¬ 
mitted, according to our best authority, through 
the air. 

Paragraph 514 

The germs that cause the disease live for a 
long time; cases have been reported where they 
lasted for months and even years. One case we know 
of where the room was not properly disinfected after 
a child had a very severe case of scarlet fever, and 
the walls were repapered. Years afterwards another 
family who had two small children moved into the 
house. The paper was torn off the wall, which 
caused the house to become infected with scarlet 
fever, and both children contracted the disease 
and died. 

Paragraph 515 

It is so contagious that great care must be 
taken to disinfect all articles of clothing used in 
connection with the case, or else everything should 
be burned, and the room must be thoroughly disin¬ 
fected. As soon as the child shows any symptoms of 
scarlet fever it should be put to bed, and remain in 
bed until the peeling of the skin is complete, 


Page One Hundred Ninety-eight 






DISEASES OF CHILDREN 


which will take, from the beginning of the disease, 
from four to six weeks, and in many cases a great 
deal longer. 

Paragraph 516 

In this country (America) the disease is more 
frequent in the fall and winter months than it is 
during the summer, yet it occurs at any time and the 
cases are just as severe in the summer as they are 
during the winter. 

Paragraph 517 

The majority of cases of scarlet fever occur 
between five and ten years of age, and the next fre¬ 
quency is between two and five years. Scarlet fever 
is common in children up to twelve and fifteen years 
of age. The period of incubation, that is from the 
time the child is exposed to the disease until the 
first symptoms appear, is from a few days to a week, 
some cases a few days longer, all depending on the 
susceptibility of the individual. 

Paragraph 518 

The mortality in scarlet fever is about ten 
per cent. The first symptoms noticed are often 
very acute. The child may seem perfectly well, and 
within a few hours time will complain of a sore 
throat, will vomit and have a high fever, the pulse 
will become full and rapid, and from 24 to 36 hours 
from that time the rash appears. It is fist noticed 
on the neck and chest. It is of a bright scarlet 
pin-point flush, and occupies the sites of the hair 
follicles. The rash extends from above downward, 
spreading in a few hours to the arms. Usually in 24 
hours after its first appearance the rash reaches 
the trunk, abdomen and legs. 

Paragraph 519 

In comparing the different eruptive diseases, 
you will notice there is a marked contrast between 
scarlet fever, measles, chicken-pox, or smallpox; 
that scarlet fever rash is much less marked upon the 
face and cheeks; that is, the skin of the face imme¬ 
diately about the nose or mouth remains free from 
the eruption. The rest of the skin on the body be¬ 
comes a scarlet red, and if the finger is drawn over 


Page One Hundred Ninety-nine 





LECTURES OF INTEREST TO WOMEN 


the skin, it leaves a white line. The rash general¬ 
ly lasts from five to six days, and in mild cases it 
may last a much shorter time. 


Paragraph 520 

As the rash begins to disappear, the skin 
starts to peel off. This peeling requires, as men¬ 
tioned, from two to six weeks, or longer. The scaling 
or peeling off is a fine flaky scale; sometimes it 
comes off in large patches. The duration of the 
peeling depends largely upon the severity of the 
case, and the peeling remains longer where the skin 
is thick, like on the hands and feet. These-fine 
flaky scales afford means for carrying the disease 
from one person to another. 


Paragraph 521 

In scarlet fever we have a varied fluctuation 
as to the severity of the disease; some cases are 
very mild, others very severe, and the complications 
of scarlet fever are to be dreaded even more tl^an 
the disease itself. It affects the kidneys, the 
ears, lymphatic glands, the eyes, oftentimes swell¬ 
ing of the tonsils and side of the neck, .and inflam¬ 
mation of the mucus membrane of the throat. 

The fever generally subsides at the time the 
rash disappears. Sometimes the fever remains 
longer, especially the child will have a temperature 
in the evening. Some cases may be very mild and have 
very severe complications, while other cases may 
be very severe and have no complications. 


Paragraph 522 

NURSING TREATMENT:—Nursing a case of scarlet 
fever, by a nurse or mother, requires the greatest 
care in every detail, which is necessary for the 
welfare of the patient, as well as preventing com¬ 
plications and the infection of other children. The 
patient and mother ,or nurse, must be isolated, and 
she should wear a dress that can be washed. Keep 
the hair covered with a suitable cap, and allow no 
other children or members of the family to enter 
the room. 


Page Two Hundred 




DISEASES OF CHILDREN 


Paragraph 523 

The patient must have plenty of* fresh air, and 
the temperature of the room should be in the neigh¬ 
borhood of 70 degrees. The patient must remain in 
bed and be protected from all draughts. A warm 
sponge bath should be given twice daily, morning 
and evening. The warm bath has a good effect in 
eliminating any profuse perspiration, also controls 
the fever. Alcohol and warm water in proportion of 
a few tablespoonfuls of alcohol to a basin of water 
makes an excellent solution for the bath. 

Paragraph 524 

The diet in scarlet fever is important on 
account of preventing inflammation of the kidneys. 
Authors differ in regard to this point, but the 
weight of authority is in favor of giving a strict 
milk diet during the height of the disease, and a 
mixed milk and farinaceous diet during convales¬ 
cence. It is by far the safest. If the exclusive 
milk diet is in any way objectionable, it can be 
diluted with line-water, or a carbonated water. If 
it disagrees with the patient, it may be peptonized. 
It milk becomes distasteful, it can be mixed with 
bailey water. 

Paragraph 525 

It is a good idea, when necessary, to change 
from the milk to oyster or clam broth, but do not 
allow the patient to have any of the oysters or 
clams. Barley water, orangeade, or lemonade may be 
given freely. Vanilla ice-cream or lemon ice, both 
plain, may be given in small quantities. Finely 
cracked ice, or shaved ice in small quantities, 
flavored with a little lemon or orange juice, makes 
a most grateful addition to the diet. 

Let the diet be as simple as possible for 
three weeks or longer, then add additional foods 
from day to day. Great care should be taken in 
scarlet fever patients in regard to the diet, as 
carelessness in diet may cause severe nephritis in 
a very mild case of scarlet fever. During conval¬ 
escence, the diet should be gradually increased. 
The increase in the diet may be made according to 
the following list: milk-toast, junket, custard, 


Page Two Hundred One 




LECTURES OF INTEREST TO WOMEN 


farina pudding, oranges, rice pudding, baked apple, 
bread and milk, sago or tapioca pudding (with or 
without apple), cornstarch pudding, and boiled 
custards. 

Paragraph 526 

When there is any kidney trouble, a liquid 
diet composed mostly of milk should be given for a 
month or six weeks. When returning to a meat diet, 
first allow only a small quantity of boiled or baked 
fish, soft part of oysters, soft-boiled eggs, and 
meats that are easily digested-—such as chicken, raw 
or very rare beef in small quantities. Remember 
that during the height of the disease, meat extracts 
or broths containing meat should be avoided. 

Paragraph 527 

The bed linen should be changed each day. The 
eyes should be protected from the light, that is, 
direct sunlight, if the room is located where you 
get plenty of sunshine (and if this is possible so 
much the better). The ice-cap should be placed on 
the head while the fever is high. When the eruption 
causes itching that annoys the child, the body 
should be rubbed with sterile olive oil, cold cream, 
carbolized vaseline or melted cocoa butter. All are 
very good; possibly cocoa butter is the best. The 
mouth and throat, in scarlet fever cases, should re¬ 
ceive special attention, and the teeth should be 
thoroughly cleaned two or three times a day with a 
brush and boracic acid solution. 

Paragraph 528 

It is a nurse’s duty to pay special attention 
to the kidneys. As a rule the urine is scanty, and 
it is necessary to give special attention to the 
kidneys in order to get the proper elimination of 
the poison. Lemonade is very agreeable to the 
patient, and also serviceable in stimulating the 
secretion of urine. See that the child drinks 
plenty of water; keep the kidneys active. See that 
the bowels move two or three times a day, using some 
of the saline laxatives like the one put up by 
Abbott, or citrate of magnesia. Give one or two 
teaspoonfuls of Saline Laxative in half a 


Page Two Hundred Two 






DISEASES OF CHILDREN 


glass of water once or twice a day, or one to two 
tablespoonfuls of citrate of magnesia as needed. 
Give saline enemas if necessary. 

Paragraph 529 

NOTE.—At the be-ginning of scarlet fever, or 
when the child begins to have the first symptoms, 
have it seen, by the family physician, or child 
specialist, in order that the correct diagnosis may 
be made, and the child may receive the proper medi¬ 
cal treatment. Remember that scarlet fever re¬ 
quires watchful care, both from the physician and 
nurse, in order, if possible, to avoid complica¬ 
tions. Do not forget that proper disinfection 
should be carried out in every detail at the close 
of the case. The child should have a bath with a 
solution of bichloride of mercury 1-5000, including 
the scalp, carried into another room and dressed in 
clean clothes, and should remain in the house for a 
few days before allowing it to go out of doors. The 
room in which the child was sick should be thorough¬ 
ly fumigated and carefully cleansed as directed by 
the attending physician or health department. The 
nurse or mother who nursed the case, before going 
out, should have the same bichloride bath as given 
to the child, with a complete change of clothing. 

MEASLES. 

Paragraph 530 

Measles is an acute infectious disease, very 
contagious, and associated with a skin eruption and 
fever. Measles occur in children of all ages, but 
it is not as common in infants under one year of age 
as it is in later childhood. It is communicated, as 
a general rule, from one person to another. We sup¬ 
pose it might be transmitted by the third person, 
but such a thing is very rare. 


Paragraph 531 

Measles is caused by specific micro-organism, 
the character of which we are not very familiar with. 
Children can contract measles three or four days 
before the rash appears on the skin, and the con- 
contagion continues until all the scale-like par- 


Page Two Hundred Three 






LECTURES OF INTEREST TO WOMEN 


tides of skin come off. Some children take measles 
very easily, while others require more or less in¬ 
timate contact. 


Paragraph 532 

A child who has been exposed to measles will 
show the first signs in from nine days to two or three 
weeks; generally it is along about the ninth to the 
fourteenth day. At the beginning of a case of measles 
the child’s condition resembles that of a common 
cold; that is, there is a running of the nose and 
eyes, dry cough, sneezing, and the child feels sick 
and often feverish, or sometimes it has a slight 
chill. This condition lasts for about three days, 
when the skin eruption begins to make its appearance 
on the face and neck, and is often seen at the begin¬ 
ning of the fourth day. 


Paragraph 533 

The temperature may vary a great deal, being 
very high at first, and then drop to almost normal 
on the second or third day, when the temperature will 
take another rise as the rash appears. After the 
rash is well out on the fifth day, it will remain 
out for about two days and then begin to fade in order 
of its appearance. After the rash fades the skin 
peels off in very fine bran-like particles. It re¬ 
quires from eight to ten days for this peeling to 
take place. 

Paragraph 534 

The character of the rash is very pronounced, 
and quite different from any other eruptive skin 
disease. It is of a dark red or purplish color, and 
the blotches may be round, oval, or irregular, and 
the skin between the rash remains normal. The erup¬ 
tion will extend all over the body, including the 
palms of the hands and the soles of the feet. It is 
first a small red spot, which continues to enlarge 
until it becomes large blotches, and it leaves a 
distinct area of normal skin between the eruptions. 
Sometimes the blotches run together, making large 
ones. The face becomes swollen more or less when 
the rash is at its height, and we have seen some cases 
where the eyes were almost closed at this time. 


Page Two Hundred Four 




DISEASES OF CHILDREN 


A patient suffering with measles usually has a 
cough that is quite troublesome. The eyes become 
inflamed, the urine is generally scanty, the tongue 
is coated, and the breath very offensive. When the 
rash reaches its height, the constitutional systems 
generally subside. 

Paragraph 535 

Among the complications that are often met 
with in measles is laryngitis, which is an inflamma¬ 
tion of the throat. This is more or less frequent, 
and oftentimes fatal. It may occur very early in 
the disease. Broncho-pneumonia is the most frequent 
and most fatal of any of the complications of 
measles. Generally three weeks time is required to 
elapse before the child who has had measles is per¬ 
mitted to mingle with healthy children, and the 
child should be quarantined during that time. 

Paragraph 536 

NURSING TREATMENT:—The nursing treatment 
consists of hygiene and diet. The. temperature of 
the room should be no less than 68 degrees F. and 
not more than 74 degrees. Do not bundle up the 
patient, or keep the room very hot, because this will 
have a tendency to cause the child to take pneu¬ 
monia. Remember that over-heated rooms cause more 
trouble during the treatment of acute lung troubles 
than any other one factor. 

Paragraph 537 # 

Place the child in a room that is well sup¬ 
plied with fresh air and light, turning its back to 
the light so that the glaring sun rays will not 
strike the child’s eyes direct. To keep the room 
dark is practically of no value, and it does not pro¬ 
tect the eyes. Give the child plenty of water to 
drink. The mouth and teeth should receive special 
attention—keep them very clean. Wash out the eyes 
with boracic acid solution. Do not overload the 
child with bed clothes, or keep it too warm. At the 
same time the child must be kept out of all draughts. 


Paragraph 538 

The child should receive a warm sponge bath 
daily, followed with a good rubbing of the entire 


Page Two Hundred Five 






\ 

LECTURES OF INTEREST TO WOMEN 


body with cocoa butter. The diet should be light, 
and food that is easily digested, largely liquids, 
soups, broths, etc. Such drinks as grape juice, 
orangeade, lemonade, or a small amount of ice cream 
are especially valuable to relieve the thirst. 

Paragraph 539 

If the fever is high, food should not be given 
too often, as we know fever conditions impair diges¬ 
tive functions. If a child has been fed every three 
or four hours, it is a good idea, under such condi¬ 
tions, to lengthen the time to four or five hours, 
especially while the child has fever. Pure milk 
should be given to an older child, but a young in¬ 
fant who has been receiving only pure milk should 
receive half milk and half oatmeal water. If it has 
been fed every three hours, it is beneficial and 
wise to try every four hours, especially while the 
child has fever. Do not forget to let the child have 
plenty of water. 

Paragraph 540 

NOTE: Measles, like all other acute infecti¬ 
ous diseases, requires the services of a physician, 
and every case should be under his care, in order 
that he may watch for any complications which may 
arise, and give such special orders in the nursing 
of the case as it may require. 

WHOOPING COUGH. 

* Paragraph 541 

Whooping cough is one of the common infectious 
diseases of childhood, characterized by a paroxys¬ 
mal cough or whoop, and children of all ages may 
contract it; even young infants are especially 
liable to have it if exposed. Always keep a child 
with whooping cough away from other children, be¬ 
cause it is very contagious from the first, and the 
infection continues to last while there is the least 
whoop or cough, which generally lasts from six weeks 
to two months, and the child should be quarantined 
during this time. 

Paragraph 542 

It requires from two to twenty days after the 
child has been exposed before the symptoms develop, 


Page Two Hundred Six 





DISEASES OF CHILDREN 


yet as a general rule, after fourteen days have 
passed since the exposure, and no cough has devel¬ 
oped, we can say with a marked degree of certainty 
that the child will not have the disease, and it is 
free from the infection. 

Paragraph 543 

When a child begins to have a cough that occurs 
at various intervals, and most frequently at night, 
we always suspect whooping cough; especially is 
this true when the cough increases in severity from 
day to day. At first a child who is taking whooping 
cough has a catarrhal condition similar to taking a 
cold. It is an irritant cough; the child has no 
fever at the beginning, no vomiting, very little (if 
any) expectoration. The cough is more severe at 
night than it is during the day, and the child is 
very restless. 

After the second or third week of such an infec¬ 
tion, the cough appears in spasms and ends in a 
whoop. During the cough or paroxysm, the face often 
becomes flushed or cyanotic in appearance. Some¬ 
times the coughing ends in vomiting, and when the 
coughing is very severe, it often causes nosebleed. 
This whoop stage lasts from three weeks to six 
months. 

Paragraph 544 

The cause of whooping cough is a specific 
micro-organism. Children with catarrhal condi¬ 
tions, enlarged tonsils and adenoids, are very sus¬ 
ceptible to whooping cough. Any diseased condition 
of the lymphatic glands, tubercular and syphilitic 
children, poor hygienic surroundings, children liv¬ 
ing in congested districts where there is very 
little sunlight and fresh air, and infants who are 
artificially fed are all more susceptible to whoop¬ 
ing cough than the child who has normal health and 
lives under proper surroundings. 

Paragraph 545 

The severity of the case of whooping cough 
depends on how well the child is able to retain the 
food, and the amount of rest it gets, and the free¬ 
dom from any complications. If we can maintain the 
child’s strength with the proper food'and assist 


Page Two Hundred Seven 






LECTURES OF INTEREST TO WOMEN 


nature in securing rest at night, we have accom¬ 
plished two very important factors in the care of 
the child who has whooping cough. 

Paragraph 546 

NURSING TREATMENT:—The nurse or mother who 
has the care of a case of whooping cough can do a 
great deal for the child, and you should be familiar 
with the requirements in such cases. Fresh air, 
that is open air treatment, if the weather will per¬ 
mit, to be continued night and day, is of the utmost 
importance. In stormy weather when the child can¬ 
not be kept out in the open air, it should remain in 
the house with the windows wide open. In winter 
time, with the body properly clad, it can receive 
the open air treatment as well as in the summer time, 
and remember that fresh air for the patient suffer¬ 
ing with whooping cough will do more for the child 
than anything else you can do. 

Paragraph 547 

If you will note the number of coughing spells, 
and their severity, that occur in the 24 hours, as 
the case progresses you can tell the improvement 
that is taking place. If the child vomits frequently 
and does not retain its food, then it must be fed at 
frequent intervals, and not so much at a time. 

Paragraph 548 

The diet that is most beneficial in such cases 
should consist of foods that are easily digested and 
contain the most nourishment. Infants should have 
peptonized milk in place of the usual formula. 

Older children’s diet should consist largely of raw 
scraped beef, custard, buttermilk, ice-cream, 
orange juice or yolk of egg beaten up with milk, and 
these foods should be given immediately after the 
coughing, in case the child has vomited food 
previously taken. 


Paragraph 549 

In the nursing of whooping cough, you will 
find cases where the question of giving the child 
sufficient nourishment becomes a serious one, and 
the diet should receive special attention. Another 


Page Two Hundred Eight 



DISEASES OF CHILDREN 


thing to do is to relieve the distress caused by 
coughing. This is done by applying an abdominal 
support, one that fits very snug, and oftentimes 
an adhesive bandage of zinc oxide snugly applied 
around the ribs on both sides will give relief. Such 
a bandage may be left in position for several days. 
It is placed next to the skin and must be examined 
carefully each day, and when it causes too much 
irritation of the skin it must be removed. 

Paragraph 550 

Whooping cough often proves fatal, especially 
with infants, and never recommend or allow mothers 
to expose their children to whooping cough with the 
idea of ‘‘just getting it over with.*’ Such a 
practice should not be recommended. 

So in conclusion, you have three things to do 
in whooping cough; that is, see that the child has 
plenty of fresh air; see that it is properly fed, 
and that it receives sufficient nourishment and 
retains it; and assist in relieving pain, caused by 
the coughing, by using a properly fitted abdominal 
.binder or support, or the adhesive bandage. 

As whooping cough is an acute infectious 
disease, the room in which the child sleeps should be 
disinfected carefully, and especially is this true 
after the child has recovered. 

Paragraph 551 

NOTE: All cases of whooping cough, require 

more or less medical attention, as severe cases 
require more or less supportive - treatment, which 
should be prescribed only by a physician. Vaccine 
is used and recommended by many physicians, and no 
doubt has its value. The same can be said of drugs 
that assist in controlling spasms and give the child 
rest at night, and control its general strength. 

DIPHTHERIA. 

Paragraph 552 

Diphtheria is one of the acute infectious 
diseases in which we are able to determine the exact 
cause. It is a specific micro-organism that is 


Page Two Hundred Nine 





LECTURES OF INTEREST TO WOMEN 


known as Klebs-Loef'f'ler bacillus. It is a disease 
that is mostly met with in children. It is occasion¬ 
ally seen in young infants, but most frequently 
occurs between the fourth and tenth year. Children 
are especially susceptible to diphtheria between 
the ages of one and five years. 

Paragraph 553 

It is transmitted from one person to another 
by direct contact, by a third person, clothing, 
toys, food and wall-paper (similar to scarlet fever 
infection), and the infection is capable of living 
an indefinite length of time. 

Diseased conditions of the tonsils and chil¬ 
dren with adenoids afford a fertile field for the 
infection of diphtheria, and it is wise to keep a 
child’s throat in as healthy a condition as possible 
in order to guard against the disease, thus pre¬ 
venting the child from becoming infected. The mor¬ 
tality in diphtheria ranges from 7 to 25 per cent, 
with the use of antitoxin; without antitoxin the 
average is much higher. 

Paragraph 554 

The infection of the disease causes a mem¬ 
brane to form in the throat and nasal passages, 
which has a yellowish white appearance, and it is 
firmly adhered to the parts affected. It is a dis¬ 
ease that has a marked effect on the nervous system, 
as well as the heart, spleen, lungs, and liver. We 
have different types—those that are considered 
mild, and others that are severe, as well as the 
septic type. 

A child who has been exposed to diphtheria 
generally shows some symptoms in from two to five 
days—generally within a week after the exposure 
the disease will be well developed. The first symp¬ 
toms noticed in ordinary cases of diphtheria are 
fever, loss of appetite, a general tired, worn-out 
condition, with sore throat, and if the mother or 
nurse will examine the throat when the child com¬ 
plains of the above symptoms, after it has been ex¬ 
posed to diphtheria, she will notice that the ton¬ 
sils are swollen and perhaps have some white spots 


Page Two Hundred Ten 





DISEASES OF CHILDREN 


on them, but nothing more can be seen. Within 24 
hours, a white membrane appears on one or both ton¬ 
sils, and very soon may extend to other parts of the 
throat. 

The above symptoms continue, and the glands 
at the side of the neck may become swollen, and a dis¬ 
charge from the nose occurs. The membrane that 
forms on the throat is not always alike; sometimes it 
may be that only a thin gray membrane is located on 
one tonsil, or maybe both sides, and then again the 
membrane may be a thick grayish color firmly adhered 
to the tonsils, and all the rest of the surrounding 
tissue be swollen more or less. One thing to bear in 
mind in diphtheria is that the soreness in the throat 
is not marked, and generally the swallowing is not 
so difficult as we get in ordinary throat troubles 
like tonsillitis. 

Paragraph 555 

Diphtheric membrane grows very rapidly, and 
unless given proper treatment, it is apt to spread 
upon the surrounding mucus membrane, extending up 
into the nasal passages, or down into the wind pipe, 
and when this latter condition occurs, there de¬ 
velops what is known as membranous croup. The child 
becomes hoarse and, if the disease continues, 
breathing becomes very difficult, and the case 
resembles a severe case of croup. This form of diph¬ 
theria is very dangerous and must receive the proper 
medical attention if the child is to be saved. One 
attack of diphtheria does not immune a child from 
another, but rather makes it more susceptible. 

Paragraph 556 

NURSING TREATMENT: A nurse or mother who 
has the responsibility and care of children, as soon, 
as there is any membrane formed in the throat,.or 
even yellow spots are seen on the tonsils, should 
summon medical aid at once. No mother should 
attempt, under any circumstances, to try to treat 
any throat conditions herself. 

A child should be put to bed, and no other 
children should be allowed to come near until a 
physician has made the proper diagnosis. If this is 
done, the mother may save her other children from 


Page Two Hundred Eleven 


LECTURES OF INTEREST TO WOMEN 


the disease in case it proves to be diphtheria. 
Antitoxin has given wonderful results in the treat¬ 
ment of this disease, and the parents should not 
object to its use. 

It is the nurse’s or mother’s duty to see that 
the bowels move every day by giving some simple 
laxative like Phillip’s Milk of Magnesia, or what¬ 
ever may be ordered by the physician. The mouth and 
teeth should be kept clean, and the urine examined 
occasionally by the nurse or physician. 

The child must be kept quiet in bed, and the 
diet should consist of milk and broths at first, and 
gradually return to solid foods. Careful man¬ 
agement in the diet in diphtheria is of the greatest 
importance, because we must maintain the patient’s 
nutrition, or the body will not be able to withstand 
the effects of the poisons that are introduced into 
the circulation. 

Paragraph 557 

If a nursing infant should become infected, 
some authorities (Koplik for one) advise that the 
child be taken from the breast, and the milk obtained 
with a breast pump and fed to the child with a bottle 
or spoon, thus preventing infection of the breast. 
However, if the mother has been rendered immune, 
the danger of breast infection is very slight. 

When there is fever, the food should be 
liquids at regular intervals, such as milk (plain 
or with lime-water), also peptonized milk, albumin 
water, liquid peptonoids, soups, gruels, and malted 
milk, which constitute the menu for liquids. Some¬ 
times semi-soldis are swallowed even with greater 
ease than liquids, and then well-cooked cereals, 
gelatin, custards, soft-boiled or.poached egg, 
or milk toast may be given, also ice-cream in small 
quantities. 

Paragraph 558 

If for any reason, the patient cannot swallow, 
we must resort to nutritive enemas. When it is 
necessary that the physician perform intubation in 
cases of membranous diphtheria, there is no special 
rule for feeding these cases, or changing the diet. 
It is a good idea to place the child’s head lower than 
the body, as recommended by Castelberry, and in this 


Page Two Hundred Twelve 





DISEASES OF CHILDREN 


position the swallowing becomes easy. The child’s 
head may lie across the nurse’s or mother’s lap 
with its head thrown well back and down. 

In feeding diphtheria patients, it must be 
remembered that food may be refused because of 
nausea, or because the child has no desire to take 
anything, as well as to any actual difficulty in 
swallowing. 

Paragraph 559 

The fever, generally speaking, is never very 
high in diphtheria, and it is best controlled by 
sponge baths with a little alcohol in luke warm 
water. The general nursing requires keeping plenty 
of fresh air in the room, clean linen, etc., which 
should be done in any a case of sickness, together with 
the physician’s orders. 

NOTE: Diphtheria is very often accompanied 
by serious complications, and let us impress upon 
you the importance of medical did at the beginning 
of any throat trouble, and if it should prove to be 
diphtheria, then antitoxin can be administered 
early in the disease, and in sufficient amount, so 
that the child is more likely to escape such com¬ 
plications as paralysis, broncho-pneumonia, kidney 
diseases and heart disease. 

The infection is so contagious, and of such 
long life, that it is absolutely necessary that the 
greatest care must be taken in disinfecting and 
fumigating the room and everything in connection 
with treating the child. It should have a bi¬ 
chloride bath (the same as in scarlet fever) and be 
freshly dressed before it is allowed to communicate 
with other children. This fumigation, when pos¬ 
sible, should be under the supervision of the Board 
of Health. 

MUMPS. 

Paragraph 560 

Mumps is one of the acute infectious diseases 
that is characterized by swelling on the sides of 
the face, just in front of, and below, the ear. This 
disease affects the parotid glands. It occurs more 
frequently in cold and wet seasons than it does in 
summer. It is a disease that occurs all over the 


Page Two Hundred Thirteen 




LECTURES OF INTEREST TO WOMEN 


world, and children of any age may have it, but it 
occurs more frequently between the ages of 6 and 15 
years. Boys are more liable to an attack than girls. 
Children as a rule are not as susceptible to mumps 
as they are to some of the other infectious diseases. 

After a child has been exposed to the infec¬ 
tion, the appearance of the disease does not occur 
until from 14 to 25 days. The period of incubation 
is usually about three weeks. The infection occurs 
by contact from one person to another, and children 
should be quarantined until the swelling is entirely 
gone, and for several days (about a week) after the 
child seems perfectly well. 

The disease is ushered in with a swelling and 
pain of the parotid gland, accompanied with fever, 
which is oftentimes quite high (104 degrees or more) ; 
generally the temperature is only about 100 to 101 
degrees. The swelling extends in front of, below, 
and behind the angle of the jaw. It also spreads 
forward on the cheek and downward along the neck— 
the center of the swelling being immediately under 
the lobe of the ear. The child has a loss of appe¬ 
tite, often vomits, and generally has pains in 
the legs. 

One or both sides may be involved, either at 
the same time or at different intervals; that is, 
one side may be affected and the swelling begins to 
subside, when the other side becomes affected. 

The swelling and pain is often so severe that the 
mouth cannot be opened very wide. 

The disease is self-limiting, the swelling 
lasting only four or five days, and inflammation 
never terminates in suppuration. Death rarely, if 
ever, is caused by mumps. The complication that 
occurs most frequently is inflammation of the tes¬ 
ticle. This generally occurs when the disease is 
prolonged, and the patient has been up and around 
more or less. The orchitis generally lasts several 
days, and may be prolonged several weeks. 

Paragraph 561 

NURSING TREATMENT: The nursing treatment of 
mumps is very simple. Keep the child in bed as long 


Page Two Hundred Fourteen 



DISEASES OF CHILDREN 


as it has any fever, and as long as the glands are 
swollen, it should be confined in one room. Keep the 
bowels regular with Phillip’s Milk of Magnesia; or 
some other simple laxative. 

The diet should consist mostly of liquids and 
gruels, including milk, while the child has fever and 
the swelling is very great, because the mouth can 
only be opened a little, and solid foods cannot be 
taken at all where there is marked swelling and a 
great deal of pain. If the fever is high give alco¬ 
hol sponge baths, and place an ice-bag on the child’s 
head. Hot fomentations in some form will assist 
greatly in relieving the pain, and are well borne 
by the patient. The use of flaxseed meal poultice, 
towels wrung out of plain hot water, or warmed anti- 
phlogistine may be applied; especially using the 
antiphlogistine at night, as it does not require 
changing as frequently as the poultice or hot fomen¬ 
tations—they should be changed at least every 
half hour. Give the child plenty of water to drink, 
which will have a tendency to relieve the dryness of 
the mouth and throat. 

NOTE: When the above treatment does not give 
relief, it is well to consult the family physician, 
and he may prescribe what is required to control the 
fever, or any medical applications to be applied 
locally. If any complications arise notify the 
physician at once. 

CHICKEN-POX. 

Paragraph 562 

Chicken-pox is another of the acute in¬ 
fectious diseases which generally occurs among 
infants and children—rarely seen in adults—and 
it generally occurs between the second and tenth 
years of age. It is a specific infection which is 
characterized by an eruption of vesicles that appear 
over the entire body. This skin eruption appears in 
successive groups, and generally lasts from four to 
fourteen days. Some cases are very mild, while 
others are very severe. 

The little vesicles are transparent and have 
thin walls, and when rubbing the finger over them 
they feel like little shot buried under the skin. 


Page Two Hundred Fifteen 




LECTURES OF INTEREST TO WOMEN 


They first contain a fluid-like serum, and are very 
easily ruptured. In some cases only a very few of 
the vesicles appear, while in others they may be 
completely covered. One attack usually immunes the 
child from another during the rest of its life. 

One point to remember in chicken-pox is that 
during the height of the disease, all stages of the 
eruption may be seen on the same part of the body— 
that is, the beginning of the visicle, others fully 
developed, and some dried up. The eruption gener¬ 
ally appears on the face first, and spreads rather 
slowly to other parts of the body. The vesicles are 
not uniform—some are small and others may be 
quite large. 

Children with chicken-pox have very slight 
fever, and oftentimes are not sick enough to go to 
bed. If the above points are kept in mind it will 
not be difficult for you to diagnose a case of 
chicken-pox. 

Paragraph 563 

NURSING TREATMENT: While chicken-pox is a 
very simple disease, you should not be careless in 
caring for the case. A child should be kept in bed 
when it has any temperature, and it should be iso¬ 
lated. A healthy child should not be allowed to 
come in contact with a child that has the chicken- 
pox for at least two weeks, or until the crusts have 
all fallen off and the skin is perfectly clear and 
smooth again. You will see that the bowels are kept 
regular, and give the child plenty of water to 
drink, and a liquid diet with feedings at regular 
intervals. 

Paragraph 564 

It should wear a loose-fitting linen or 
muslin garment. The skin may be dusted with a dust¬ 
ing powder of cornstarch and rice powder (equal 
parts), or you may use stearate of zinc. When itch¬ 
ing is very severe, use carbolized vaseline, or a 
paste made by mixing bicarbonate of soda with cold 
water. When this paste is applied to the irritated 
skin it is very cooling. 

Paragraph 565 

Do not allow the child to scratch the erup¬ 
tions or molest them in any way, as serious infection 


Page Two Hundred Sixteen 



DISEASES OF CHILDREN 


may result if this is permitted. The scratching 
can often be prevented by having the child wear an 
aluminum mitten, the same that is used to cure the 
thumb or finger sucking. While it is not necessary 
to disinfect the room after chicken-pox, it is well 
to see that it is thoroughly cleaned. 

NOTE: In severe cases, and where the child 
does not seem to be getting along nicely with the 
nursing treatment, or if any complications arise, 
have the case seen by a physician in order that it may 
receive the proper medical attention. 

SMALLPOX. 

Paragraph 566 

Smallpox is an acute infectious, as well as 
a contagious disease, and most frequently seen in 
unvaccinated children. It is rarely met with in 
children who have been properly vaccinated. It 
occurs in very young infants who have not been 
vaccinated. Smallpox is characterized by a skin 
eruption that consists of reddish-like specks which 
resemble flea bites. 


Paragraph 567 

The rash feels like a small shot. It may 
appear on any part of the body, and the shot-like 
forms continue to increase in size. About the sec¬ 
ond day the eruption develops into papules, and dur¬ 
ing the fourth or fifth day of the disease the 
papules become vesicles, which are filled with a 
little clear watery fluid at the apex. They are 
cone shape and red in appearance, and look somewhat 
like chicken-pox, but in chicken-pox they are filled 
with a fluid almost from the beginning. 

The vesicles develop into pustules, and begin 
to separate generally on the sixth day. They have 
a decided yellowish tint, creamy-like in appear¬ 
ance, due to the formation of pus cells. This con¬ 
dition exists until about the twelfth day, when 
the pustules rupture. After the pustules are 
emptied, either by rupture or absorption, they dry 
up, leaving a blackish crust, and the crust sep- 


Page Two Hundred Seventeen 




LECTURES OF INTEREST TO WOMEN 


arates from the body between the second and third 
week. The desquamation generally lasts from one to 
two weeks, and after the skin is free from any 
crusts, so to speak, we consider the patient as 
cured. 

Paragraph 568 

The cause of smallpox is likely a specific 
micro-organism, of which we believe has not yet 
been defined. When smallpox occurs in children 
under ten years of age (that have not been vac¬ 
cinated) , it has been reported by some authorities 
that between 50 and 60 per cent. die. 

Paragraph 569 

It is a clinical fact that resistance of the 
infection with children is less than that of adults. 
Nursing infants frequently become infected. In 
cases with young infants, the mouth, nose, and 
throat complications interfere very seriously with 
their feedings; often the cause of fatal results. 

Paragraph 570 

The infection, in all probability, is con¬ 
tained in the vesicles, pustules, or crusts—the 
micro-organisms existing in these factors. It is 
transmitted through the air, and infection may take 
place some distance from a person suffering with 
smallpox. It is transmitted from one person to 
another, and also from bedding or clothing worn by 
an infected person. Even entering a room during 
the pustular or desquamative stage is sufficient to 
communicate the disease. 

Paragraph 571 

It is a disease that is very contagious, and 
the infection has a remarkable tenacity of life and 
will remain active for some time in the clothing or 
in the scabs that form. The long life of the infec¬ 
tion is similar to that of scarlet fever. The 
severity of the disease is in degree only; some cases 
are mild and others very severe. It is often very 
mild in cases that have been properly vaccinated. 
As a rule, one attack is a protection against the 
second, yet patients may have smallpox the second or 
third time—such cases have been reported. The 


Page Two Hundred Eighteen 



DISEASES OF CHILDREN 


disease occurs more often in cold seasons. It may 
occur at any period of life, especially when not 
protected by vaccination. 

Paragraph 572 

The first symptoms that are noticed in the 
patient who is coming down with smallpox are head¬ 
ache, pain in the back, high fever, drowsiness and 
vomiting, and in young children, usually convul¬ 
sions. The pulse rate is increased in children as 
high as 150 to 160. Respirations are labored and 
frequent. The temperature rises rapidly, and often 
the first day it is 103, and continues to increase 
until it reaches 105 or more by the time the eruption 
appears. After the eruption is well developed, the 
temperature drops to normal. It is well to remem¬ 
ber that in no other eruptive disease does this 
normal condition of the fever occur. Some cases 
are so mild that the above symptoms are hardly 
noticed, and in others they are very marked. 

As mentioned, smallpox is always more severe 
in unvaccinated children, especially when they are 
very young, and in these cases the prognosis is 
always bad, while in vaccinated children the prog¬ 
nosis is always good. 


Paragraph 573 

The complications that are most common in 
children suffering with smallpox are inflammation 
of the mucus membranes of the nose, mouth, and 
throat, and broncho-pneumonia. You will remember 
that broncho-pneumonia is also one of the frequent 
complications of measles. 

Paragraph 574 

NURSING TREATMENT: Patients must be placed 
in the very best sanitary surroundings with plenty 
of fresh, air, and every case should be under strict 
quarantine. In the cities all the cases are in¬ 
variably sent to the pest-house. The bowels should 
be kept thoroughly cleansed, and if the fever is 
high and delirium develops, give the patient a tepid 
pack. An ice-cap on the head, and cold colon flush¬ 
ings are recommended. These all have a tendency 
to make the patient more comfortable. 


Page Two Hundred Nineteen 






LECTURES OF INTEREST TO WOMEN 


Paragraph 575 

The diet for a patient suffering with small¬ 
pox should be very light and nutritious during the 
fever stage, such as broths, custards, fruits, cold 
drinks, orangeade and lemonade, also ice cream. 
After the fever subsides, a more liberal diet can be 
given in the way of toast, baked potato, bacon, soft- 
boiled egg, boiled vegetables of any kind, broiled 
or baked fish, chicken, broiled chops, and all kinds 
of fruit. Patients that relish it can be given 
milk. Care should.be taken that milk be given at 
the proper time, and not in combination with any of 
the acid fruits. 

Paragraph 576 

Give plenty of water to drink at all times 
during the disease. Local applications on the rash 
is not considered to be of any great value. Three 
per cent, solution of carbolic acid and glycerine 
is recommended by some, or carbolized vaseline may 
be used. At the beginning of the rash, if the face 
is covered with a cold cloth wrung out of ice water, 
it is very soothing to the patient, and has a ten¬ 
dency to allay the irritation. It may be continued 
at intervals until the pustules form. After the 
pustules are formed, the open air treatment seems 
to have a beneficial action on the eruption, and 
does as well as applying any medication. 

Paragraph 577 

To prevent the face from pitting, the pustules 
should not be irritated by scratching. One thing 
that may be done which is beneficial, would be to 
open the little pustules as soon as formed, and 
evacuate the pus. This would keep most of the pus 
from being absorbed, and also stop the destruction 
of so much tissue, thus preventing pitting. 

NOTE: After every case of smallpox a most 
thorough disinfection and fumigation is required of 
everything that has come in contact with the case. 
This must be done to prevent the spread of the dis¬ 
ease. A physician should be summoned at the begin¬ 
ning of the disease, in order that the case may 
receive proper medical attention, and complica¬ 
tions be avoided. 


Page Two Hundred Twenty 



DISEASES OF CHILDREN 


It is essential that every child under school 
age should be vaccinated if we wish to protect the 
child against smallpox, or if it should take the 
disease it will be milder in its course, and the 
attack much shorter. Fischer says: ‘‘When we con¬ 
sider the ease with which we can confer immunity, 
and protect the human body against smallpox, then 
it seems nothing less than criminal to permit an 
innocent human being to go about unvaccinated.’’ 

Fathers and mothers who do not believe in 
vaccination, object to it because of their ignorance 
as to its value. We recommend that every child 
should be vaccinated by a physician, and when per¬ 
formed, as it is today, under strict antiseptic 
conditions, the results are most gratifying. 

. PNEUMONIA 

Paragraph 578 

Pneumonia is an acute infectious disease 
which occurs very frequently in infancy and child¬ 
hood. It is caused by a specific micro-organism 
known to the medical profession as the pneu¬ 
mococcus. It is a disease of short duration, 
generally lasting from six to nine days. It is a 
self-limiting disease, and terminates in two 
different ways, by crisis or by lysis. By the term 
crisis we mean that the temperature returns to 
normal in a few hours and the patient is practically 
well. When it terminates by lysis, it requires 
several days to become normal and the child recov¬ 
ers gradually. 

Paragraph 579 

Pneumonia occurs more frequently in chil¬ 
dren between the ages of 5 and 10 years. It gen¬ 
erally affects only one lung at a time; the right 
lung being more affected than the left, and the 
lower lobes are more frequently affected than the 
upper. Statistics show that in a given number of 
cases the lower lobe of the left lung becomes 
affected more often than any other part of either 
the right or left lung. 

Paragraph 580 

Children who are delicate or poorly nour¬ 
ished are more susceptible to the infection, and 


Page Two Hundred Twenty-one 



LECTURES OF INTEREST TO WOMEN 


oftentimes a sudden chilling of the body will bring 
on an attack. Coolidge thinks that the melted snow 
and high winds of March are responsible for many 
cases, as the germs found in the street filth are 
readily carried about by the wind. 

Paragraph 581 

Pneumonia in children develops very suddenly, 
accompanied by a chill, vomiting or convulsions. 
Children who can talk will complain of headache, 
pains in the side, and often pains in the abdomen. 
Respirations are increased very early in the dis¬ 
ease, and the nostrils become active. This, accom¬ 
panied with the characteristic little grunt at each 
respiration when the nostrils move in and out as the 
child breathes, are all indications of pneumonia. 
There is very little, if any, coughing and if there 
is, it is of a dry hacking nature. There is very 
little expectorating in cases of children. Consti¬ 
pation is the rule, and in young babies there may be 
diarrhea. 


Paragraph 582 

The pulse is also increased ,but the ratio 
that normally exists between the pulse rate and 
respirations is greatly disturbed. We might say 
that the normal ratio is one to four; that is, a child 
breathes once to four beats of the heart, but when 
the child breathes, say 60 times, and the heart 
beats only 140 times, then we have a condition that 
is present in pneumonia. The temperature will vary 
from 102 to 106, or even 107. The very high tem¬ 
perature we find in children who have rickets more 
than any other class. Ordinarily the temperature 
varies from 102 to 104. 

The character and frequency of the pulse is 
of great importance in pneumonia. The pulse may be 
very high, 140 or more, and be quite regular and 
full, which is not a serious condition, but when it 
is weak and thready, and often not so frequent, such 
a case is in great danger of collapse, and requires 
frequent and careful stimulation, as advised by 
the attending physician. When the pulse rate has 
been 120, and suddenly increases to 140 or more, it 


Page Two Hundred Twenty-two 





DISEASES OF CHILDREN 


requires careful examination on the part of the 
physician in order to determine the cause of this 
sudden increase in the pulse rate. 

Paragraph 583 

NURSING TREATMENT: The duty of the nurse or 
mother in caring for a case of pneumonia is to keep 
a correct record, for the physician, of the pulse 
rate, respirations, temperature and the character 
of the heart’s action, or rather the character of 
the pulse, also the amount of urine secreted. 

A case of pneumonia should be placed in a room 
by itself, and all healthy persons should be ex¬ 
cluded. Fischer makes it emphatic that pneumonia 
in children should be isolated as strictly as a case 
of diphtheria. The important point in caring for a 
case of pneumonia is to keep the child well nour¬ 
ished. Assist in controlling the temperature, and 
lessen the frequency and increase the depth of 
respirations. 

Paragraph 584 

As stated, pneumonia is a self-limiting dis¬ 
ease, and it will generally run its course regard¬ 
less of what we do. The amount of nourishment that 
a pneumonia case can assimilate to keep up its 
strength generally tells us whether a child will get 
well or succumb to the disease. 

If it agrees with the child, milk should be 
given throughout the disease, also buttermilk. 
Farina and milk, oatmeal and milk, rice and milk, 
are all excellent foods, and with these foods the 
amount of milk given is increased. Cold foods, such 
as tapioca, corn starch and rice puddings, are of 
value. When the children are old enough, say from 
2 to 3 years, a small amount of ice-cream, freshly 
made of cream, is very nutritious. Of the hot foods, 
chicken broth, veal broth, or mutton broth may be 
given. Albumin, in the form of the raw white of an 
egg, may be given. A soft boiled egg may also be 
given to older children. 


Paragraph 585 

The digestion is below normal in pneumonia 
cases, and it is a good practice not to feed the 


Page Two Hundred Twenty-three 



LECTURES OF INTEREST TO WOMEN 


infant too often. For bottle-fed and nursing 
babies, the time should be lengthened from a half 
hour longer between feedings than when it was in a 
normal condition; that is, if you were feeding the 
baby every three hours, when it has pneumonia feed 
it every 334 or 4 hours, if this is possible. The 
same is true in feeding older children, and in order 
to overcome the heart depression, they should be fed 
regularly every four or five hours, and the night 
feeding is as important as the day. 

As mentioned, good nourishment is imperative, 
and the child must be fed at night. It is not a good 
idea to let the child sleep through the night with¬ 
out taking nourishment; therefore, nursing and 
artificially fed infants, as well as older chil¬ 
dren, while they have fever, should receive nutri¬ 
tion every three or four hours, both day and night, 
because they demand large quantities of liquids, 
and as stated, a favorable termination of pneumonia 
can only be accomplished when the depressed vi¬ 
tality of the system is’stimulated by the proper 
amount of nutrition. 

Paragraph 586 

In some cases, with children of poor digestion, 
or weak and delicate children, it may be necessary 
to predigest the food, or peptonize it, and at the 
same time it may be necessary to dilute the food, 
and in such cases it may be advisable to dilute the 
food one-half its usual strength, in order that it 
may be assimilated so that the child will receive 
a sufficient amount of nutrition. Children who 
cannot assimilate their food well may be given 
liquid peptonoids in addition to other foods. 

Orange juice may be given throughout the disease. 

It helps to keep the bowels regular and relieves the 
thirst. 

Paragraph 587 

The room which is occupied by a pneumonia 
patient should be supplied with plenty of fresh air. 
The temperature should be from 65 to 70 degrees F., 
and this given temperature should be maintained 
throughout the disease. Always remember how very 
important it is in nursing a case of pneumonia, to 


Page Two Hundred Twenty-four 





DISEASES OF CHILDREN 


have the room well ventilated, and see that the 
patient gets a sufficient amount of food. These 
are two essential factors—don’t forget them. 


Paragraph 588 

Now to reduce the temperature, the entire 
body should be sponged with equal parts of alcohol 
and water. It should be just luke warm, and such a 
sponge may be given every hour if the temperature 
requires it. Then when the temperature is not high 
the sponge bath may be given only in the evening 
and morning. When a child is sleeping comfortably 
do not waken it to give it a bath because the tempera¬ 
ture registers 104 or 105. The child must be care¬ 
fully watched, and it must be treated when the tem¬ 
perature is too high and the child is restless. 

When the temperature is too high, some authors 
request that the child should be placed in a cold 
or ice pack to reduce the temperature. The cold 
applications to the chest in children, as a rule, 
are not well borne, and alcoholic sponges, with an 
occasional ice, or cold pack, will be found effectual. 

Paragraph 589 

If the cough is troublesome, inhalations of 
steam may be tried, and if a child complains of a 
pain in the side, apply a mustard plaster. A pneu¬ 
monia jacket should be put on at the beginning of 
the disease. This prevents the surface of the 
lungs from being chilled, and maintains a uniform 
temperature. The chest, front and back, should be 
thoroughly rubbed with hot camphorated oil two or 
three times a day. 

The hands and feet must be kept warm with 
clothing in the way of mittens and socks, also hot 
water bags to the feet. Wash out the child’s mouth 
several times daily with glyco-thymoline or boro- 
lyptol, or any good mouth wash. See that the bowels 
move daily, and this is best accomplished by giving 
enemas with a salt solution, and in case of very 
high fever we must remember that enemas, in which 
the chill is taken off the water, will assist greatly 
in reducing the temperature. In high temperature 
the ice cap should be applied\o the head. 


Page Two Hundred Twenty-five 





LECTURES OF INTEREST TO WOMEN 


NOTE: The medical treatment for pneumonia 

is important, not so much as to the administration 
of drugs as it is to the careful attention that a 
case of pneumonia requires, in order to give the 
mother or nurse the proper instructions as the 
case progresses. The physician should be called 
when any of the first symptoms of pneumonia appear, 
and make daily visits thereafter, in order to pre¬ 
vent or treat complications at the proper time and 
give the little ones the best chance for their 
lives in this disease, which often proves fatal. 

INFLUENZA. 

Paragraph 590 

Influenza is a very acute infectious disease 
characterized by a catarrhal condition of the 
respiratory tract. It is a disease that affects 
the mucus membrane of the nose, throat and lungs, 
as well as the stomach and bowels, and causes a pro¬ 
found shock to the nervous system. The disease gen¬ 
erally occurs in epidemic form, and spreads from 
one case to another. It seems to occur more fre¬ 
quently in cold and damp weather, and as a rule one 
attack immunes a person from another, yet the same 
person may have several attacks. 

Paragraph 591 

The disease is caused by a very small bacillus 
discovered by Pfeiffer in 1892. The symptoms of 
influenza in the adult are very marked, and the 
diagnosis is not very difficult. In children, 
especially in infants and young children, there is 
a marked difference in the symptoms, which often 
makes the diagnosis very difficult. 

A child who has been infected with influenza 
may show the first symptoms any time within a few 
hours to a week after being infected. The disease 
may begin very abruptly, and the child become very 
ill at once, or it may come on gradually. The child 
will be indisposed and languid for several days be¬ 
fore the acute symptoms begin. When children are 
old enough to give the physician intelligent 
knowledge, the diagnosis is not so difficult. 


Page Two Hundred Twenty-six 




DISEASES OF CHILDREN 


Paragraph 592 

The disease, as mentioned, affects the lungs, 
stomach, bowels, and nervous system. A child may 
have any one of the three definite types, or all 
types may occur in the same individual; or any two 
may be most prominent. That is, in one case it may 
be the lungs, stomach and bowels, or in another case 
it may be the brain and nervous system in combina¬ 
tion with the lungs. The nervous type is the most 
serious, especially when complicated with the 
respiratory tract. An attack of the disease that 
affects the stomach and bowels, we find most fre¬ 
quently in infants and very young children. 

The course of influenza in children varies. 
Some are sick only a few days or a week, and others 
require months to affect a complete recovery. The 
temperature generally lasts six or seven days, and 
often reaches 104 or 105, or even higher, during 
the height of the infection. 

A child who is perfectly healthy and strong, 
with the heart in good condition, without any com¬ 
plications developing, has a much better chance for 
recovery than the bottle fed babies, or children 
with a tendency to rickets. In both cases the re¬ 
sistance is below the average. Such children are 
more susceptible to various complications which 
would naturally invite fatal termination. Sec¬ 
ondary infection of the lungs means a grave prog¬ 
nosis . 

Paragraph 593 

A child infected with influenza generally 
has a high fever at the beginning, and feels very 
ill, often accompanied with convulsions and vomit¬ 
ing. If old enough, the child will complain of an 
aching body and a headache, and will also complain 
of being chilly. There is sneezing and running of 
the nose, and the eyes have a peculiar red and in¬ 
flamed appearance. More or less bronchitis de¬ 
velops, also loss of appetite. The child seems 
prostrated and does not care to be moved. 

When the stomach and bowels are involved there 
is a coated tongue, vomiting, and often diarrhea. 


Page Two Hundred Twenty-seven 





LECTURES OF INTEREST TO WOMEN 


One of the complications of influenza in children is 
the severe catarrhal condition extending to the ear, 
and developing mastoid trouble. In some cases the 
kidneys become involved. The secondary infection 
of the lungs is a very common complication, both 
in children and adults, and in all probability 
'causes more deaths than any other one complication 
in influenza. 

Paragraph 594 

NURSING TREATMENT: The nursing treatment 
of influenza is as important, if not more so, than 
the medical treatment, and the patients who do not 
receive the proper care and nursing, run a great 
risk of losing their lives. It is a disease that 
cannot be trifled with, and the lack of proper 
care was the cause of more deaths during the recent 
epidemic in 1918, than any other one element. There 
are two things that are absolutely necessary for 
the welfare of the patient: 

First: As soon as the patients begin to feel 
sick they should be put to bed and remain there for 
two or three days after the fever has subsided. 

Now, when we say ‘‘remain in bed,’’ we do not mean 
that the patients should get out of bed to go to the 
toilet, or get up and sit in a chair, and it is best 
that they do not even rise up to take a drink of 
water. Water and all hot liquids should be taken 
through a medicine tube. 

Paragraph 595 

Second: A patient should receive no nour¬ 
ishment whatever during the fever stage. 

Now, if the nurse and patient will* strictly 
adhere to these two conditions, they will do more 
towards the recovery of the patient than anything 
else they can do. When we say ‘‘not to give any 
nourishment’ we are just as emphatic about it 
as we are when we say, 4 ‘Go to bed and stay there. ’ * 

All .the nourishment that the patient should 
have is orange juice, a little grape juice, and 
plenty of water to drink. No milk, or any o.ther 
kind of liquids, should be given during the fever 
stage. As soon as the fever is all gone, then 
begin giving soups, broths, and some kind of liquid 


Page Two Hundred Twenty-eight 




DISEASES OF CHILDREN 


nourishment every three or four hours. During 
this time the patient remains in bed, and after 
there has been no temperature for three days, the 
patient may begin to sit up for a short time; the 
first day in bed with a back rest, and the second 
day get out of bed into a chair and gradually 
regain their strength before they venture out of 
the house. 

Paragraph 596 

When there is any lung trouble, mustard 
plasters should be applied to the chest once or 
twice daily, both front and back, and when there is 
any secondary infection of the lungs put on a pneu¬ 
monia jacket and apply freely camphorated oil to 
the chest. 

Paragraph 597 

Make the patient comfortable by giving sponge 
baths once or twice a day during the fever stage, 
and the bowels should be flushed out once a day with 
a normal salt solution. Great care should be taken 
in moving the patients or taking them up quickly 
from the pillow. 

Paragraph 598 

The above nursing treatment refers to adults 
and older children. Infants would be very hard to 
manage without giving them a little nourishment, but 
let it be very weak, and do not give any more than is 
absolutely necessary. They should be given what 
they have been accustomed to taking, only in very 
diluted form; not more than one-quarter normal 
strength. That is, if a baby nine months old has 
influenza, and it is bottle fed, it should be given 
a modified milk formula for a two or three months 
old child, and that sparingly. 

Young children, as a rule, have grip very 
lightly. It is the older children and adults who 
suffer the most. Children are treated the same as 
adults, and should receive the same care and 
attention. 

Paragraph 599 

NOTE: The medical treatment of influenza is 
important in connection with the correct nursing. 
If any individual has an idea that he is strong 

Page Two Hundred Twenty-nine 






LECTURES OF INTEREST TO WOMEN 


enough to overcome the average infection of grip, 
and throw it off without proper nursing and medical 
aid, he is badly mistaken. It is the over exertion 
and excessive food that causes a strain on the 
nervous system, and complications develop which 
result in death. 

Every case of influenza demands the most 
careful medical attention in order to carry the 
patient safely through such a violent infection, 
and to prevent complications. If we can impress 
upon your mind the two important factors mentioned 
in the nursing treatment—to remain in bed, and 
take no food during the fever stage—we have accom¬ 
plished a great deal. 

This knowledge is obtained from personal ex¬ 
perience, the writer having practiced medicine 
twenty years ago, during the great epidemic which 
swept the country at that time, as well as during 
the recent epidemic, without a death in the last 
one. This proves that the experience obtained in 
the first epidemic, when similar conditions ex¬ 
isted, are of great value in the treatment of 
influenza. 


TYPHOID FEVER. 

Paragraph 600 

Typhoid fever is one of the acute infectious 
diseases, and like diphtheria, we know the cause, 
which is a specific micro-organism called Eberth’s 
typhoid bacillus. It is a disease that is rarely 
seen in infants, or in children under five years of 
age. Most of the cases that occur in children are 
from five or six years to the sixteenth year. More 
cases are noticed as the child grows older. Typhoid 
fever cannot be considered a child’s disease, be¬ 
cause it occurs in adults as frequently, if not more 
so, than it does in children. 

Paragraph 601 

The disease is contracted by drinking impure 
water or milk that is infected with typhoid bacil¬ 
lus. Some foods—like oysters, cheese or butter— 
may also carry the infection. The disease is not 


Page Two Hundred Thirty 





DISEASES OF CHILDREN 


contagious like measles, scarlet fever or diph¬ 
theria, as drinking water or food is the source of 
infection. It is a disease that affects the lining 
membrane of the intestines, and the infection may 
be present in the system for some time before any 
symptoms begin to appear. 

Paragraph 602 

The period of incubation in typhoid fever is 
from one to two weeks, but rarely extends over three 
weeks. 

When a child is suffering, or coming down 
with typhoid fever, it begins by complaining of be¬ 
ing tired, and is quite languid, has headache, and 
maybe some vomiting, constipation or diarrhea 
exists, which is about equally divided in all cases. 
The abdomen.is generally distended and fever is 
present. The temperature is one of the main points 
in telling whether the child has typhoid fever or 
not. It rises at night and falls in the morning, 
and keeps increasing a little both night and morning 
for the first week or so—a sort of a step-ladder 
type of fever—until the height is reached. The 
temperature remains high for about a week and then 
drops to normal again in the same manner in which it 
developed; that is, a little lower each day both 
morning and evening. The temperature is reasonably 
high in typhoid fever, ranging from one to five 
degrees. This is the typical course for an ordinary 
case of typhoid fever. 

Paragraph 603 

There is often delirium, severe headache, and 
stupor. In children suffering with typhoid fever, 
we rarely see hemorrhage of the bowels or perfora¬ 
tions of the intestines as we do in adults. There 
is more or less cough accompanying typhoid, which is 
a sort of a typhoid bronchitis. When we have 
typhoid, and the only symptoms are fever and cough, 
the diagnosis is very difficult. 

Paragraph 604 

There is an examination of the blood in chil¬ 
dren suffering with typhoid known as the Widal re¬ 
action, and if it is the first attack that a child 


Page Two Hundred Thirty-one 



LECTURES OF INTEREST TO WOMEN 


has, it makes the Widal test more valuable, yet it 
should not be the only means of making the diagnosis. 
Remember the Widal serum test must be made by an 
expert laboratory man. Many examinations of the 
Widal serum test may be necessary in order to assist 
in making the diagnosis of a difficult case. 

The examination of urine, giving what is 
known as the diazo reaction, may be of some value as 
to revealing the nature of the disease quite early 
in the attack. 

Paragraph 605 

NURSING TREATMENT:—The treatment is very 
important in typhoid fever. The general care and 
comfort of the patient, the administration of 
food, and general management of the diet are very 
important factors in the treatment of typhoid fever. 

The nurse or mother must learn most thorough¬ 
ly how to feed a typhoid patient. On account of the 
high and long continued fever, we must remember 
that there is a very low vitality in the digestive 
and absorptive powers. The action of the intes¬ 
tines is greatly interfered with, and there must be 
just as much care exercised in treating a mild case 
of typhoid as a severe one. Do not forget to give a 
mild case the same careful attention that you would 
a severe one as regards the diet. 

Typhoid fever patients rarely care for food, 
and should not be consulted in regard to what they 
shall or shall not take, but food and drink should 
be given at regular intervals both day and night, 
and should be given every four hours (some cases 
oftener), and the amount to be given should be gov¬ 
erned according to the condition of the patient, 
which must be ascertained by the physician. 

To quench the thirst, pure water is probably 
the best, but if there is no bowel trouble fruit 
juices may be added to the water. Lemonade, orange¬ 
ade, raspberry juice, or grape juice can be used to 
good advantage, and is welcomed by the patient. 
Weak tea with the addition of a little red wine, 
given ice-cold, is an excellent thirst quencher. 
When there is severe diarrhea, weak tea and red wine 
are especially preferred. Albumin water, flavored 


Page Two Hundred Thirty-two 






DISEASES OF CHILDREN 


with lemon or orange juice, or a little sherry or 
brandy with ice added, is very useful, because it 
not only gives the patient a drink, but food as 
well. 

Remember that large quantities of water, 
when it causes no unpleasantness, is of great value 
in typhoid, and it helps to eliminate the toxic 
conditions through the kidneys, and has a tendency 
to relieve the nervous symptoms that accompany 
typhoid fever. 

Probably the food par excellence in typhoid 
fever is pure milk. Some patients will not care for 
it, and it will often disagree with some; while in 
others i't will give us the ideal diet, as there is no 
food that meets so many requirements. The amount to 
be given depends upon the age of the child and the 
condition of the patient, and it should be pre¬ 
scribed by the attending physician. 

We question if it is a good plan to give plain 
milk exclusively to children during the entire 
period of typhoid fever. Experience teaches that 
if plain milk is given exclusively, it is only a 
question of time when it will disagree with the 
patient. 

The simplest method is to add from one to 
three ounces of lime water to each glass of milk. 
Plain or mineral water may be used instead, or a 
pinch of salt may render milk more palatable to 
children, and the addition of a teaspoonful, or 
less, of brandy may be relished by others. 

Paragraph 606 

Milk may be given cold and flavored with 
fruit juice, vanilla or nutmeg, or it may be given 
in the form of ice cream. Equal parts of barley 
water and milk may be well borne when properly pre¬ 
pared and boiled together for a few minutes. 

It must be remembered that all foods should 
be liquid. In addition to the milk, whey, butter¬ 
milk, strained soups and broths of all kinds may 
be given. These are best at the beginning, and 
later in the disease strained gruel, chocolate, and 


Page Two Hundred Thirty-three 




LECTURES OF INTEREST TO WOMEN 


chocolate with malted milk may be added to the menu. 
These may be given alternating with milk. When 
there is any stomach trouble, and digestion is 
poor, then the milk must be predigested. When milk 
is not well taken, and does not agree with the 
patient, then the yolk of a raw egg added to the 
barley water may be substituted for milk. 

Paragraph 607 

When there is any diarrhea or loose condition 
of the bowels, acid water is very beneficial, and 
makes an excellent drink, and is also a good thirst 
quencher. It is made by adding 8 to 10 drops of 
either dilute phosphoric acid or dilute hydro¬ 
chloric acid to a tumbler of sweetened water. 

It is not only important to carefully feed a 
typhoid patient during the fever stage, but the 
feeding of the convalescent patient is equally as 
important. Do not give solid food for several weeks 
after convalescence is thoroughly established, on 
account of the great danger of hemorrhage. Soups 
may be thickened with sago, farnia or barley, and 
the yolk of a raw egg may be added to the soup as well. 
Liquid peptonoids and panopeptone are also of 
value. Do not take the responsibility of giving 
solid food to a patient convalescing from typhoid 
fever until you are directed to do so by the attend¬ 
ing physician. 

Paragraph 608 

To control the fever, it is best accomplished 
by cold packs or sponging; also the cold bath is of 
great value to reduce fever, and is recommended by 
some physicians. 

The hygienic measures in typhoid must not be 
forgotten. Owing to the infectious nature of the 
discharges, the stools and urine must be thoroughly 
disinfected; also the sputum, providing there is 
any cough or expectoration present. In fact, all 
discharges should be received in vessels contain¬ 
ing five per cent solution of carbolic acid, or a 
strong solution of chloride of lime. A strong solu¬ 
tion of copperas should be thrown in the toilet 
from time to time while a typhoid patient is in the 
house. 


Page Two Hundred Thirty-four 




DISEASES OF CHILDREN 


Paragraph 609 

All clothing, such as bed linen, handker¬ 
chiefs, nightgowns, as well as the dishes used by 
the patient, should be soaked in a 1-2000 bichloride 
solution for at least a half an hour before being 
washed. 

Sunlight is the great disinfectant in typhoid 
fever, and the room should be selected that gives 
the greatest amount of sunshine and fresh air as it 
is possible to obtain. 


Paragraph 610 

NOTE: Typhoid fever requires daily medical 
attention. While in young children the disease is 
more favorable than in adults, complications are to 
be watched for, and should immediately receive med¬ 
ical attention. Some of the unfavorable conditions 
in typhoid are the distended abdomen, frequent 
bleeding from the bowels, weakened and depressed 
nervous system, and the poor assimilation of food. 

If complications develop late in the disease 
it is unfortunate, because the child is in a weak¬ 
ened condition and will be unable to cope with any 
serious complications. 

Typhoid fever in children generally termi¬ 
nates earlier than in adults. It may run its three 
or four weeks course, but this is not the rule. The 
older the child, the more the disease will take on 
the adult time. The course of typhoid fever in in¬ 
fants is generally entirely different from older 
children. 

I 

Prophylactic treatment of typhoid fever is 
accomplished by the injection of typhoid vaccine, 
and should be given as deemed advisable by the at¬ 
tending physician. 

The following table is the period of incuba¬ 
tion of the acute infectious diseases just men¬ 
tioned, and this will help the mother to know just 
when the child will become sick after being exposed 
to any of these diseases. 


Page Two Hundred Thirty-five 




LECTURES OF INTEREST TO WOMEN 


Paragraph 611 

PERIOD OF INCUBATION. 


Chicken-pox. 

.Average 7 to 14 days 

Possible 5 to 21 days 

Diphtheria. 

.Average 5 to 7 days 

Possible 2 to 12 days 

Influenza. 

.Average 2 to 3 days 

Possible. 7 days 

Measles. 

.Average 11 to 14 days 


Possible 9 to 21 days 

Mumps. 

.Average 7 to 14 days 

Scarlet Fever. 

.Average 2 to 6 days 


Possible few hours to 15 days 

Typhoid fever. 

.Average 7 to 14 days 

Whooping-cough. 

.Average 5 to 7 days 

Possible 4 to 21 days 


Paragraph 612 

The other infectious diseases have no posi¬ 
tive periods of incubation; therefore, after a child 
has been exposed to any of them, one cannot tell 
just when to expect the first symptoms. 

The following diseases and conditions are not 
infectious; therefore, there is no definite period 
of incubation. 

Paragraph 613 

BRONCHITIS. 

Bronchitis is an inflammation of the 
bronchial tubes, and it may be primary or secondary. 
It often complicates some of the acute contagious 
diseases, such as measles or whooping cough, and 
children who have deficient nutrition, or cases that 
are weakened from having rickets, or catarrhal 
conditions, enlarged tonsils or adenoids, are all 
liable to develop an attack of bronchitis any time. 

Bronchitis may be very mild or it may be very 
severe. When mild, it generally affects only the 
large bronchial tubes. It generally begins as an 
ordinary cold with a cough. The temperature in mild 
cases, where the inflammation has extended to the 
smaller bronchi, the temperature will be from 102 

Page Two Hundred Thirty-six 












DISEASES OF CHILDREN 


degrees F. to 103 degrees F. These figures refer 
to the evening temperature. 

There is more or less secretion formed in the 
mucus membrane, but children under five years of age 
rarely, if ever, expectorate. The mucus accumu¬ 
lating in the stomach and bowels often cause vomit¬ 
ing, and sometimes diarrhea. There is a loss of 
appetite, and you will notice a peculiar rattling or 
wheezing sound occur in the lungs as the child 
breaths. This can be noticed by placing the ear to 
the chest, or when the baby rests against the mother. 

Paragraph 614 

Mild cases of bronchitis last from two or 
three days to a week. In severe cases the children 
become quite sick and often have a very high tem¬ 
perature. The breathing is rapid and very labored, 
and the cough is almost constant. The hands and feet 
become cold, and the skin (of the hands and feet) 
will appear bluish. The same condition will exist 
in the face in very severe cases. This condition 
often grows rapidly worse and the child may suffo¬ 
cate by excessive secretion forming in the lungs, 
that cannot be eliminated, as it cannot expectorate. 
Yet in most cases of bronchitis infants get well. 

It affects older children the same as infants, only 
not so severe, and in older children it is not con¬ 
sidered nearly so serious. 

Paragraph 615 

The pulse rate in bronchitis is of great 
value as to the severity of the case. The pulse 
rate from 120 to 130 in young children should be 
looked upon favorably. If the pulse suddenly in¬ 
creases to 140 or 160, and respirations are in¬ 
creased from 60 to 80 per minute, the case becomes 
more serious and in all probability the child will 
have pneumonia. 

Paragraph 616 

NURSING TREATMENT: The nursing treatment of 
bronchitis is hygienic and dietetic. It is abso¬ 
lutely essential that a child with bronchitis be 
put to bed in a room, well ventilated, with a tem¬ 
perature of about 70 degrees F. , and remain in bed 


Page Two Hundred Thirty-seven 





LECTURES OF INTEREST TO WOMEN 


while it has a fever. The child should have plenty 
of fresh air, and should be kept free from dust, 
and the ventilation of the room should be such as 
not to allow the child to be in any draughts. Give 
the patient as much sunshine as possible. The body 
should be kept warm but not too warm. It is best 
that flannels be worn next to the skin. 

When the child is old enough to stand up or 
creep, or even walk, it should not be allowed to 
sit on the floor. Put it on the bed with its play¬ 
things and entertain the child, and in that way 
keep it from taking more cold. See that the feet 
and legs are kept warm by using the hot water bottle, 
or wrap the limbs in warm flannels. 

Paragraph 617 

When the temperature is high a mustard foot 
bath is of value, and a luke warm sponge bath, fol¬ 
lowed by rubbing with a coarse towel, will stimulate 
the circulation, and is very soothing to the child. 
Remember hot baths must not be given, and the room 
should never be overheated. Coolidge says that the 
correct temperature for the room during the day is 
68 degrees F. and at night 55 degrees F. 

Paragraph 618 

Mustard plasters applied to the chest are of 
great value in bronchitis. The plaster should cover 
the entire chest, both front and back, and should be 
warmed before applying. It should be left on 
just long enough to cause the skin to become red¬ 
dened. A mustard plaster must be carefully 
watched, and examined from time to time, to see that 
it does not cause too much irritation of the skin. 
The time required will vary from five to thirty 
minutes, because children differ as to the amount 
of irritation that the skin will stand. It should 
remain until the skin is quite red. 

Paragraph 619 

The mustard plaster is better applied at 
night than in the morning. After it is removed the 
chest is dried quickly and rubbed with camphorated 
oil. A fresh plaster must be made each time. In 


Page Two Hundred Thirty-eight 




DISEASES OF CHILDREN 


severe cases it may be necessary to repeat the 
plaster every three or four hours, but generally 
once or twice a day is sufficient. 

Paragraph 620 

One of the important things in the nursing 
treatment is to see that the child takes plenty of 
nourishing food. This is very important, as the 
child’s strength must be supported with the proper 
amount of nourishment. When a child refuses food by 
the mouth, then rectal feeding should be employed. 

Foods should be selected that are easily 
digested, and those that will give the greatest 
amount of nourishment. Predigested milk should be 
given to feeble infants, and whey, soups and broths 
should not be forgotten. The yolk of an egg beaten 
up in sherry wine for older children will give the 
proper nourishment and stimulation. See that the 
child drinks plenty of water. 

Paragraph 621 

It is important to remember that a sick child 
cannot assimilate the same amount of food that it 
can when well; therefore, it is well to give a small 
amount at first, and gradually increase it as the 
child’s condition improves. This is also true of 
young infants. When breast fed they may be given a 
little plain water or barley water before each 
nursing, and let the nursing period be a little 
shorter than usual. Also remember that older chil¬ 
dren should have a liquid diet during the fever 
stage. 

NOTE: The medical treatment of bronchitis 
is very important, not from the fact that the child 
needs so much medicine, but it needs careful watch¬ 
ing to note how the child is progressing, so do not 
neglect calling a physician early in the disease 
in case it does not immediately respond to home 
treatment. Here the old adage, ‘‘A stitch in time 
saves nine,’’ is very appropriate. 

The child needs certain medication, and 
treatment with steam inhalations, with properly 
selected drugs that will be indicated in a given 
case, will be found a very valuable means of remov¬ 
ing the secretions that accumulate in the bronchial 


Page Two Hundred Thirty-nine 



LECTURES OF INTEREST TO WOMEN 


tubes, and such treatment has a decided effect in 
controlling the disease. At the same time such 
inhalations act as a stimulant to the respiratory 
tract. 

Paragraph 622 

TONSILLITIS. 

Tonsillitis is an acute inflammation of the 
tonsils, and it is probably one of the most fre¬ 
quent diseases of childhood. It is seen oftener in 
childhood than in infancy, and the onset is quite 
sudden with a high fever, frequently accompanied 
with vomiting. The child complains of sore throat, 
pain when swallowing, and has a general aching in the 
joints and muscles of the neck, also accompanied 
with headache and pain in the back. 

Paragraph 623 

There is a close relation between tonsillitis 
and rheumatism. Rheumatic children are predis¬ 
posed to tonsillitis. Children who have large 
tonsils only require a slight cold to bring on an 
attack. During an attack of tonsillitis the tonsils 
become enlarged and are covered with white spots 
which are separated from each other and appear as 
as white or yellowish dots over the tonsils. 

Paragraph 624 

In tonsillitis the temperature is usually 
high, and the thermometer will register from 102 to 
103 or 104. As a rule the bowels are constipated, 
the tongue is coated, and the breath has a peculiar 
foul odor. On looking into the throat you will see 
the conditions just mentioned. As a rule, both 
tonsils are affected at the same time. Occasionally 
it begins on one side and then extends to the other. 

Sometimes the little distinct dots are so 
close together that they will unite and form one 
large patch, which you might think was diphtheria, 
but remember that a diphtheric patch is gray in 
color and covers the whole oF the tonsils, and often 
extends to other parts of the throat. Also re¬ 
member that in diphtheria the fever, as a general 
rule, is not high like it is in tonsillitis. The 
acute symptoms of tonsillitis do not last long and 


Page Two Hundred Forty 





DISEASES OF CHILDREN 


the white spots on the tonsils disappear after a few 
days, and leave a swollen red tonsil, which will 
return to its normal size in a few days after the 
spots are all gone, providing the case terminates 
favorably. 

Paragraph 625 

NURSING TREATMENT: The important features in 
the nursing of tonsillitis is the general care and 
administration of food, as there is usually so much 
pain in swallowing that no solid food can be taken, 
and cold foods are more acceptable to the patient. 

It is best to give them in small quantities and in 
liquid form as much as possible. Food that is nu¬ 
tritious and soothing to the inflamed throat is a 
little ice-cream, ice-cold jellies and ice-cold 
drinks, like orange juice and grape juice. Any cold 
foods that a child.can swallow with comfort is more 
agreeable than anything hot, and it must be remem¬ 
bered that during the fever the diet must be liquid, 
and then a little later blanc mange or fruit jellies 
may be given, which should be cold, and it will be 
soothing to the throat and easily swallowed by the 
child. A child suffering from tonsillitis should 
be kept in bed and as quiet as possible. Sponging 
with alcohol, and enemas twice a day will be of 
great value in controlling the fever. 

Paragraph 626 

NOTE: The most serious cases of tonsillitis 
should be left entirely to the physician, who should 
be consulted at once. Until he arrives, give the 
child an enema and a good cathartic of anything you 
may have on hand. Sprays and gargles are used in 
treatment of these cases, and the mother should 
teach her child how to gargle, using plain water, 
and then when it is necessary to use any medication 
it can be easily done and will be effectual. 

A mother should examine a child’s throat 
often, using a teaspoon to depress the tongue, so 
that a physician can make a good examination, and 
the child is familiar with the manner in which it is 
done, and will not offer any resistance. It is a 
good plan, when the mother is examining the throat, 
to have a little electric battery to throw a light in 
the throat. This will teach the child not to be 


Page Two Hundred Forty-one 





LECTURES OF INTEREST TO WOMEN 


afraid of such an examination as the physician will 
employ when a child is real sick, and the throat 
needs to be examined. 

Paragraph 627 

CROUP. 

Croup is an acute catarrhal condition of the 
mucus membrane of the throat, charactertized by 
severe spasms of the larynx. As a general rule 
croup does not occur until after the infant is six 
months old, and then until it is four or five years 
old it is very common. 

There is one thing to remember in a case of 
croup that is very important, and that is when it 
comes on suddenly at night, after the child has been 
perfectly well during the day, there is practically 
no cause for worry, as the case will terminate favor¬ 
ably; but when it comes on very slowly, and is not 
benefited by the ordinary nursing treatment, it may 
become serious and prove fatal. 

Paragraph 628 

Any condition that causes an excessive se¬ 
cretion to accumulate in the back part of the 
throat, when the child lies on its back, has a ten¬ 
dency to cause croup. Sometimes there are heredi¬ 
tary conditions where the child will have a ten¬ 
dency to attacks of croup. Such conditions as en¬ 
larged tonsils, adenoids, exposure to cold, indi¬ 
gestion and constipation are often immediate causes 
of croup. It must be remembered that if a child has 
had croup once, it is more liable to have another 
attack at some future time. 

Paragraph 629 

An attack of croup usually develops very 
suddenly at night, and often without any warning. 
Sometimes we can suspect a child will have croup 
if, during the afternoon or evening, it becomes 
hoarse and the hoarseness is accompanied by a pecu¬ 
liar barking cough. A child generally wakens from 
a sound sleep with all the signs of croup. An attack 
comes on with a hoarse barking cough, the face will 
become congested, and the little patient will be 
in great distress. It sits up in its crib strug- 


Page Two Hundred Forty-two 


DISEASES OF CHILDREN 


gling and gasping for breath, and the attack ter¬ 
minates with a long noisy high-pitched sound as the 
air is drawn into the lungs. 

Paragraph 630 

A nurse or mother who attends a severe case 
of croup for the first time, in our opinion, is not 
likely to ever forget it. While it is a most dis¬ 
tressing thing for a nurse or mother to witness, 
yet the child with the simple and acute form will 
recover quickly, and it rarely, if ever, proves 
fatal. Therefore the nurse or mother should con¬ 
trol her feelings, and show no anxiety or excite¬ 
ment, because the same nervousness shown by the 
mother will be imparted to the child, and it will 
only have a tendency to make it worse. 

Paragraph 631 

Children suffering with croup will have an 
increased pulse rate, and the temperature may vary 
from 100 to 103 degrees. The forehead, or even the 
whole body, may be covered with perspiration caused 
by the spasmodic condition of the throat, and as a 
result of the struggle for breath. 

Paragraph 632 

NURSING TREATMENT: Remember this; that in 
every case of croup the child needs attention at 
once. The well trained mother or nurse can do much 
to relieve the little patient of its suffering. 

Paragraph 633 

The first thing to do is to try to get the 
child to vomit, and the best and most simple remedy 
for this is syrup of epicac, which may be given in 
one-half to one teaspoonful doses, and repeated in 
15 minutes or a half hour until effectual, or until 
several doses are given. As soon as the child 
vomits, it will free the throat of the accumulated 
mucus, and the labored breathing will be relieved. 

If there is no syrup of epicac in the house, 
and it is impossible to obtain it, have the child 
take some warm water in which is placed a pinch of 
salt or mustard; or another'good home remedy to cause 

Page Two Hundred Forty-three 


•l 





LECTURES OF INTEREST TO WOMEN 


a child to vomit is equal parts of powdered alum and 
honey. Give the child several teaspoonfuls of the 
mixture, or a teaspoonful every 5 or 10 minutes 
until it vomits. 


Paragraph 634 

Apply very hot applications to the throat. 
Take a piece of flannel and wring it out of very 
hot water—have it just hot enough so that it will 
not burn the skin, and change the hot cloths often. 
At the same time have the child inhale steam. 

A little turpentine added to the water will be of 
value. If you happen to be so fortunate as to have 
an ordinary croup kettle at hand (one that is es¬ 
pecially designed for such cases), so much the 
better. The steaming should be continued until the 
breathing is easier. 


Paragraph 635 

A sheet is placed over the child’s head or 
crib, and steam forced in, under the tent that is 
made with the sheet, for 20 minutes at a time. 

Remove the sheet for a few minutes, then repeat the 
steaming again for 20 minutes. The steam loosens 
the secretions in the throat. Give the child a 
soapsuds enema, and get the bowels to move freely; 
and if it can be taken, give the child a dose of 
castor oil. 


Paragraph 636 

NOTE; A mother or nurse should not give 
medicine of any kind (only as mentioned above) in 
a case of croup, unless ordered to do so by the 
physician, and he should be summoned at once at the 
beginning of the attack. 

Remember that when croup appears suddenly the 
child will generally recover, as it results from 
catarrhal trouble and accumulated mucus. The 
dangerous forms of croup are the cases that come on 
very slowly—don’t forget this. Children who 
have croup at repeated intervals should not be 
allowed to stand in draughts by open windows, and 
extra care should be taken that they do not take 
cold. 


Page Two Hundred Forty-four 




DISEASES OF CHILDREN 


Paragraph 637 

Croupy children should wear flannels the year 
round, but of different weights. It is a good idea 
to sponge the neck and throat every morning, and 
give the parts so sponged a brisk rubbing with a 
salt towel. 

The attending physician should look after the 
case, and correct any nose or throat trouble that 
may be present. Keep the child out of doors as 
much as possible on pleasant days, but it should 
remain in the house if the weather is damp, accom¬ 
panied with sharp cold winds. 

Paragraph 638 

CONVULSIONS. 

In infancy and early childhood convulsions 
occur with more or less frequency, and they occur 
more often in children than they do in adults— 
rarely after the seventh year. The reason for this 
is because children have an extremely delicate 
organization of the nervous system. The child 
feels the high nervous tension which surrounds it 
much more quickly than an adult, and it suffers in 
proportion. 

Paragraph 639 

Any irritation that affects the nervous 
system to a marked degree would have a tendency to 
cause convulsions. The most frequent irritation 
of the nervous system is caused by stomach or bowel 
trouble, and when a child under your care has convul¬ 
sions, the first thing to think of as the cause is 
some abnormal condition of the stomach and bowels. 

Any diseased condition that will cause a high 
temperature may also cause convulsions; intestinal 
worms, tight foreskin on boys will also cause them. 
Any condition that has a direct irritation of the 
brain, blows or injuries to the head, are all well 
known causes of convulsions. Remember, as a rule a 
convulsion comes on very suddenly without any warn¬ 
ing. When you see an infant with a high tempera¬ 
ture, very restless, twitching of the extremities 
and eyelids, rolling the head from one side to the 
other with the eyes fixed, all are suggestive signs 
of convulsions. 


Page Two Hundred Forty-Sve 





LECTURES OF INTEREST TO WOMEN 


Paragraph 640 

Convulsions may last for only a few seconds, 
or for some minutes, and there may be only one attack 
or there may be several. One attack of convulsions 
generally makes a child more susceptible to another. 
There is a general contortion of the face and rigid¬ 
ity of other parts of the body, such as the arms and 
legs. There is often a frothing at the mouth, ir¬ 
regular pulse and breathing, and the child becomes 
unconscious. 

Convulsions that are caused by stomach and 
bowel troubles, worms, rickets, teething, or some 
other reflex condition, rarely terminate in death, 
but when they are due to direct irritation of the 
brain they are more apt to be fatal, or leave some 
lasting paralysis. 

Paragraph 641 

NURSING TREATMENT: When a child who has 
convulsions comes under your observation, and you 
are called upon to treat the attack, you will undress 
the child, quickly place it in a hot bath, and with 
the little finger vaselined (if the child is of suf¬ 
ficient age), insert it in the rectum. This 
stretching of the rectum generally causes the child 
to regain consciousness. 

Place the child in a bed in a quiet room, and 
apply a cold cloth or ice-bag to the head; wrap up 
the body, arms and legs in a large Turkish towel 
wrung out of mustard water (1 tablespoonful of 
mustard to a gallon of water) . It should be hot, the 
same temperature as the bath. Leave the mustard 
towels on the body and extremities until the skin 
becomes quite red. The cold applications should be 
kept on the head for at least half an hour after the 
convulsion is over. 

Paragraph 642 

Give a high warm saline enema as soon as pos¬ 
sible. If the ,bowels have not recently moved you 
had better give an enema first; then, after the 
bowels move good, flush out the colon with a normal 
salt solution. You will note that many times as 
soon as you clean out the bowels the convulsions 
will cease. 


Page Two Hundred Forty-six 




DISEASES OF CHILDREN 


Paragraph 643 

As soon as the child is able to swallow, it 
should be given a dose of one of the favorite 
cathartics—castor-oil should have the first con¬ 
sideration. Give a does of oil according to the 
child’s age, and repeat the saline enema in about an 
hour or two after giving the oil. 

You will restrict the diet to broths, whey, 
or chocolate mixture of malted milk, and let this 
constitute the diet for the first 24 or 36 hours; 
after that, allow a diet only gradually of solid 
foods, and then only those of an easily digested 
nature. A child who has convulsions must be kept 
very quiet and have an open air life; should have 
plenty of rest and sleep, and not be irritated or 
excited in any way. 

Paragraph 644 

NOTE: The family physician should be con¬ 

sulted to discover the cause of convulsions, and 
employ him to prescribe and treat the case in order 
to prevent further attacks, but it must be remem¬ 
bered that it is almost impossible for the physician 
to be present during a convulsion, as in most every 
case it will be over before the doctor arrives, 
therefore, we have given detail as to treatment 
during the attack. 

Paragraph 645 

ADENOIDS. 

Adenoids are growths that develop in the back 
and upper part of the throat. It is that part of the 
nasal cavity known as the naso-pharyngeal cavity. 
Adenoids is an increased growth of the adenoid 
tissue which is normally present. The adenoid veg¬ 
etations may vary in number and size. In severe 
cases they are very numerous and irregular in shape, 
and often fill the entire cavity extending over the 
tubes that lead to the ear. 

Paragraph 646 

They occur in early infancy and early child¬ 
hood. Generally the child does not develop adenoids 
until after the fourth or fifth year. They rarely 
develop later in life. New born infants have 


Page Two Hundred Forty-seven 




LECTURES OF INTEREST TO WOMEN 


adenoids; such cases are frequently seen. Fischer 
states that heredity, to some degree, plays an im¬ 
portant part in the cause of adenoids. 


Paragraph 647 

Children who have adenoids must breathe 
through the mouth. This causes a pinched expres¬ 
sion of the nose and a long drawn face, and the 
bones of the upper jaw are deformed to such a degree 
as to cause the upper teeth to become very prominent, 
and the lips become swollen and thick. Ear trouble, 
such as deafness, is often caused by adenoids, and 
the voice has a muffled nasal sound. Such letters 
as m, n, and ng cannot be pronounced. 


Paragraph 648 

Children who have adenoids often complain of 
earache, and it is of interest to note that when 
adenoids are present it is invariably associated 
with bed wetting; that is, children who wet the bed 
continually generally have adenoids. There is 
mouth breathing and more or less snoring at night. 


Paragraph 649 

Children who have adenoids usually have a 
very poor appetite, and their mental condition is 
impaired. They are also subject to bronchitis, 
croup and asthmatic conditions; take colds easly, 
and have more or less coryza. They are also ave¬ 
nues of infection, and children with adenoids are 
more susceptible of taking any of the acute infec¬ 
tious diseases. 

Paragraph 650 

NURSING TREATMENT: There is no special nurs¬ 
ing treatment in a case of adenoids, but you see 
how important it is for the child’s health that it 
should have the proper medical attention. The 
family physician or specialist should be consulted 
whenever a mother suspects that her child has ade¬ 
noids, and if present have them removed by a sur¬ 
gical operation. The attending physician will 
give directions in regard to v the care and nursing as 
the case may demand after an operation. 


Page Two Hundred Forty-eight 





DISEASES OF CHILDREN 


Paragraph 651 

RICKETS. 

Rickets is a disorder of the entire body 
caused by feeding the child improper food. There¬ 
fore, it is a disorder of nutrition. The bones are 
affected first, but it also affects other parts of 
the body; especially is this true of the nervous 
system. It usually occurs in a child’s life from 
six months to the end of the second year. 

Paragraph 652 

Bad surroundings, lack of fresh air, and not 
sufficient sunshine are conditions that greatly 
help the disease to develop. As mentioned, error 
in diet is the real cause. We find rickets in 
babies whose mothers have nursed them too long and 
given them a poor>quality of milk. Also bottle fed 
babies, on patent foods, or poor quality of cow’s 
milk wrongly prepared are frequent causes. 

In discussing this subject, let us take for 
example an infant who is developing rickets. 

Note how it affects the child so that you may be 
familiar with such conditions and secure medical 
aid in proper time. The infant is apparently well 
and in perfect normal condition; is plump, well 
nourished and has a^good color. Now from this seem¬ 
ingly normal child, the changes due to rickets 
begin to take place—namely: its color fades and it 
becomes pale; it may not get thin but the muscles 
begin to lose their tone, and when the time arrives 
for the baby to hold up its head it will make no 
attempt to do so. It does not try to sit, stand, or 
walk alone. It may walk for a short time and then 
not be able to continue doing so. It will be months 
behind the average child if it does stand and walk 
alone. These children oftentimes cannot walk when 
two years of age. 

Paragraph 653 

There is generally a strong tendency to con¬ 
stipation and skin irritation, and the baby’s head 
perspires very freely when asleep. It is very 
restless and does not sleep well. As soon as the 
above abnormal conditions begin to develop, a 
physician should be consulted in order to ascertain 
the real cause. 


Page Two Hundred Forty-nine 



LECTURES OF INTEREST TO WOMEN 


Paragraph 654 

In a well developed case of rickets the dis¬ 
ease first affects the bones, and little lumps form 
on the ribs, wrists, knees and ankles, and the end 
of the bones will become enlarged. The head be¬ 
comes very large in proportion to the rest of the 
body. The teeth are very late in coming, and they 
decay very early. The muscles and bones become 
very weak and bend very easily. Curvature of the 
spine occurs and the legs become bent, and bow-legs 
develop. The arms will bend very much like the 
legs, and bones of the pelvis will take abnormal 
shapes. These cases in girls will have a deformed 
pelvis, which will give serious complications 
during pregnancy in later life. Possibly the most 
striking symptom is the condition which develops 
from weakened abdominal muscles. The abdomen 
becomes distended and bulges to a marked degree. 

Paragraph 655 

Children who suffer with rickets offer very 
poor resistance to overcome colds, catarrh, bron¬ 
chitis, pneumonia, any of the acute infectious dis¬ 
eases, or stomach and bowel troubles. This is 
true because the mucus membranes are affected as 
well as the bones and muscles. After a child is two 
or three years old it has a tendency to recover 
from rickets slowly, probably due to the fact that 
it eats a greater variety of food. Deformities 
that develop during rickets very often remain 
throughout the child’s life. 

Paragraph 656 

NURSING TREATMENT: The nursing treatment of 
rickets is very important because it is a condition 
of nutrition, and the feeding and care of the child 
is in the hands of the mother or nurse. Therefore 
you see how important it is for you to know how to 
give children the proper kind of food to prevent 
rickets, as well as to treat the disease. 

You as a mother and nurse should thoroughly 
understand the principles of infant feeding, and if 
the mother will do this her baby will not develop 
rickets on account of any ignorance on her part 
relative to infant feeding. If a child develops 


Page Two Hundred Fifty 




DISEASES OF CHILDREN 


rickets the case should be immediately placed under 
the supervision of the physician. 

If poor surroundings exist they must be 
changed before any medical treatment will be effec¬ 
tive. Every case of rickets demands plenty of sun¬ 
shine and open windows night and day. Each child 
should receive a bath with a handful of sea salt 
added to the water. 

After the surroundings have been corrected, 
the next important step in the nursing treatment is 
the administration of the proper foods. When a 
breast fed child, who is nursing, begins to show 
signs of rickets, a chemical examination of the 
milk should be made, and if any abnormal conditions 
exist it must be corrected at once. It may be 
necessary to discontinue nursing altogether, and 
give the infant modified or plain cow’s milk; or it 
may be advisable to give a mixed feeding in such 
cases. 

When the milk is examined, and it is low in 
proteids, it is necessary for the mother to in¬ 
crease her diet of meat, eggs and cereals if she 
desires to continue nursing her child. Oftentimes 
she may do so with the mixed feeding, under her 
physician’s directions, but when the child has 
reached the age of nine months, it is a better plan 
not to try to build up the breast milk, in order to 
continue nursing the child, but wean it at once, 
giving it artificial feedings of patent foods or 
modified cow’s milk. 


Paragraph 657 

Rickety children should have plenty of cere¬ 
als, such as barley, cream of wheat, sago, farnia or 
rice, with plenty of fresh vegetables, such as 
spinach, peas and beans. Eggs, white meats, 
chicken and fish may be added to the diet list for 
older children. Fresh fruits are also valuable, 
and butter and cream must not be forgotten. Young 
children may take meat juices, orange juice, cod¬ 
dled eggs, clear mutton or chicken broths, and 
cereals cooked several hours, given in the form of 
gruel. Bacon is also of value. 


Page Two Hundred Fifty-one 




LECTURES OF INTEREST TO WOMEN 


When children who are fed on condensed milk, 
or any of the patent foods, develop rickets, you must 
change the food at once, giving modified cow’s milk 
or plain milk, and in these cases, if possible, 
secure herd milk direct from the dairy, and do not 
pasteurize it but give it properly modified or 
plain. 

In nursing a case of rickets, let it be re¬ 
membered that regularity is of great importance as 
regards time for feeding, sleep and daily exercise. 
A child should be kept in the fresh air as much as 
possible. In winter time a child should be dressed 
the same as going out of doors, and allowed to exer¬ 
cise in the room with the windows down from the top, 
so they will have plenty of fresh air, and at the 
same time be protected from direct draughts. 

Paragraph 658 

Baths are better given in the evening just 
before going to bed, and not too warm. A child may 
be placed in the tub with a temperatue of 98, and 
reduced to 90 by adding cold water. A teacup full 
of dissolved sea salt should be added to each gallon 
of water. After the bath the child should have a 
good massage. A little cocoa butter may be used on 
the hands for this rubbing. It is a mother’s duty 
to see that the bowels keep regular, as directed 
under the treatment of constipation. 

NOTE: The prescribing of mediqine should 
be left to the physician in charge, and if deformi¬ 
ties develop they must be treated by the proper 
braces or surgical operations. We must impress 
this fact upon mothers, that it is necessary that 
the deformities be corrected early in life, as it 
will prevent much suffering in later years. 

Paragraph 659 

SCURVY. 

Scurvy, in children, is a condition that is 
caused by improper feeding. It is constitutional 
and occurs in both breast fed and bottle-fed 
babies, but it is generally more common in bottle 
fed. Especially do we find such cases where they 


Page Two Hundred Fifty-two 



DISEASES OF CHILDREN 


are fed exclusively on prepared baby foods. The 
greatest number of cases occur in infants who are 
fed on condensed milk. 

Paragraph 660 

It is rarely seen during the first six months 
of a child’s life, or after the second year. The 
disease occurs in any climate and any locality, 
either in the best or in the poorest hygienic sur¬ 
roundings. We find scurvy among children who have 
been deprived of breast milk, and in those cases 
which have been fed exclusively on a milk diet and 
the milk has been over-sterilized. We find it in 
cases where children have been fed condensed milk 
or patent foods in which fresh milk has not been 
added. So we may say that the cause of scurvy is the 
absence of fresh milk in a child’s diet, regardless 
of whether it is cow’s milk or human milk. 

When scurvy is developing in a child, the 
first abnormal condition that you will notice is a 
marked irritability and restlessness that occurs 
both day and night, and the child is unable to 
sleep. The child is not satisfied with ordinary 
care and attention, and cries when the arms and legs 
are moved. There is more or less swelling of the 
legs and forearms. When the child is not disturbed 
it lies very quietly, which gives the impression 
that he is paralyzed, but it lies quiet in order 
to prevent pain which is caused by moving the 
swollen limbs. 

Paragraph 661 

A child generally loses weight, becomes very 
anemic, has loss of appetite, and when food is taken 
the child generally perspires very freely, especi¬ 
ally about the head. 

Paragraph 662 

A child with scurvy often has an afternoon or 
evening temperature of 100 to 101. The pulse is 
generally feeble, small in volume, and ranges be¬ 
tween 120 to 150. The breathing is not affected. A 
child suffering with scurvy will often stop walking 
suddenly. The gums will become spongy and swollen, 
and these conditions will develop before there is a 
general break-down. 


Page Two Hundred Fifty-three 




LECTURES OF INTEREST TO WOMEN 


Paragraph 663 

Scurvy is generally a chronic disease. The 
recovery will depend upon how quickly the vitality 
can be restored. It is necessary to continue the 
treatment for some time after the symptoms have dis¬ 
appeared, or a relapse will occur. 

NURSING TREATMENT: The nursing treatment 
for a case of scurvy begins with a change in the man¬ 
ner of living, as regards food and the hygienic con¬ 
ditions, and as it is a disease of nutrition, the 
diet treatment is of great importance. It must 
consist of fresh milk, fine potato gruel, raw meat, 
raw yolk of egg, orange juice and sugar. 

Paragraph 664 

It will not suffice to simply change the diet 
to fresh milk alone, but it is necessary to add to 
the milk some, more active agent like potatoes, car¬ 
rots, vegetable juices, or orange juice. Broths 
that contain vegetables are very beneficial. The 
vegetables mostly used in such cases are carrots 
and potatoes that have been boiled with the meat and 
strained. Raw meat juices—the blood squeezed out 
of a piece of raw round steak—seasoned with pepper 
and salt and given hot, should be added to the list. 

Together with this change of diet, it is nec¬ 
essary that the child be given plenty of fresh air 
and sufficient sunshine. In fact, a sun bath is of 
value. Care must be taken not to injure the deli¬ 
cate nature of the skin by being exposed too long to 
the sun rays. Proper ventilation of the sleeping 
apartment is of the utmost importance. 

Paragraph 665 

A child suffering from scurvy should be given 
a daily salt bath. The bath is prepared by adding 
one pound of sea salt to a tub of water. The bath 
should be given at a temperature of 95 degrees F. 
The child should remain in the bath about five min¬ 
utes, and the entire body should be massaged 
quickly and thoroughly while in the bath, and after 
the body is dried it should be rubbed with a coarse 
towel, or salt towel, until the skin has a pinkish 
color. The bath, with the friction applied to the 


Page Two Hundred Fifty-four 



DISEASES OF CHILDREN 


skin as mentioned, is very stimulating, and if given 
in the evening it has a tendency to promote sleep 
and give the child a good rest. 

NOTE: The medical treatment of scurvy is 
important, as the child needs restoritives and 
tonics in order to build up its general condition, 
and every case of scurvy should be under the care of 
the attending physician in order that he may pre¬ 
scribe the proper medication needed in each indi¬ 
vidual case. 

The difference between rickets and scurvy— 
It is noted that in rickets we have the projecting 
abdomen which does not occur in scurvy. Neither 
does the peculiar shape of the head occur in scurvy 
that is noticed in rickets. The general condition 
of scurvy resembles tuberculosis to a certain ex¬ 
tent, but the absence of the cough, respirations not 
being impaired, and no physical signs noticed in 
the lungs, all tell us the difference between 
scurvy and rickets. Sometimes scurvy and rickets 
may be found at the same time in the same child; 
both being caused by giving improver food. 


Paragraph 666 

CHILD’S DIET FROM ONE TO TEN YEARS OLD. 

It will be very convenient and interesting to 
have a diet list for the child from one to ten years 
old, and we will give you the one we think best. By 
using this list in combination with instructions 
given in weaning, it will be sufficient to give you 
the necessary help. 

When we begin to give other foods, changing 
from human milk to cow’s milk, and from cow’s milk 
to the following diet list, we know that these 
changes sometimes cause stomach and bowel trouble 
(gastro-intestinal derangements). For this rea¬ 
son, the general supervision of the stools, and 
comfort of the infant is required. If the cow’s 
milk causes constipation, which it generally does, 
such cases should receive large quantities of 
water, orange juice or prune juice, which will help 
to regulate the bowels. Cornmeal and oatmeal mush, 


Page Two Hundred Fifty-five 






LECTURES OF INTEREST TO WOMEN 


and corn muffins with butter are also very good. 

An ounce of expressed beef juice once a day is very 
good, and it has a tendency to exert a mild laxative 
action. 

The following menu is copied from Fischer, 
and selections can be made from it for each feeding 
that would be most pleasing for the individual 
case, as a child’s likes and dislikes are similar 
to those of adults. 


Paragraph 667 


DIET FOR CHILD FROM ONE YEAR TO FIFTEEN MONTHS. 
6:00 A. M. 

Milk, eight ounces (if constipated give Hor- 
lick’s Malted Milk, three teaspoonfuls in eight 
ounces of water). 

Zwieback or biscuit. 

9:00 A. M. 

Saucer of farina, hominy, or cream of wheat. 
Cup of milk. 

12:30 P. M. 

Beef or chicken broth with toast crumbs. 
Expressed beef juice over baked or mashed 


potato. 


4:30 P. M. 

Apple sauce or juice of orange. 

6:00 P. M. 


Cup of junket, 
Cup of milk. 
Biscuit. 


Paragraph 668 

DIET FOR CHILD FROM FIFTEEN TO EIGHTEEN MONTHS. 

6:00 A. M. 

Milk and crackers. 

9:00 A. M. 

If constipated, prune jelly, apple sauce, or 
orange juice. 

Add one teaspoonful of dextrimaltose to each 
cup of milk. 

9:30 A. M. 

Saucer of hominy, farnia, Scotch oats, or 
cream of wheat. 

Cup of milk. 


Page Two Hundred Fifty-six 



DISEASES OF CHILDREN 


12:00 NOON. 

Eight ounces of beef, lamb, or chicken broth, 
thickened with farina, sago, or home-made noodles. 

Coddled egg, alternate days, steamed rice 
with expressed beef juice. 

Apple sauce. 

3:30 P. M. 

Cup of milk or malted milk. 

Zwieback or biscuit. 

6:00 P. M. 

Cup of custard, junket, or steamed rice. 

Cup of milk. 

Biscuit. 

Paragraph 669 

DIET FOR CHILD FROM EIGHTEEN MONTHS TO THREE YEARS. 

6:30 A. M. 

Orange juice, apple .sauce, or prune jelly. 

7:30 A. M. 

Warm milk, eight ounces. 

Mellin’s Food, one teaspoonful, or Eskay’s 
Food, one teaspoonful. 

Zwieback or cracker with butter. 

11:00 A. M. 

Farina. 

Hominy. 

Cream of wheat. 

Oatmeal. 

Grape-nut, scalded with hot milk, in addi¬ 
tion a cup of warm milk, 6 ounces. 

2:00 P. M. 

A soup, a meat, a vegetable, and a cracker. 
Beef or chicken soup, thickened with split 
peas, sago, rice, or farina. 

Clear broth, with yolk of egg, or one or more 
ounces of expressed beef blood. 

Oyster or clam broth. 

Joint of chicken. 

Broiled halibut. 

Raw scraped steak. 

Chicken jelly or calf’s foot jelly (without 
wine flavor). 

Baked Potato with butter. 

Spinach or carrots. 

Page Two Hundred Fifty-seven 




LECTURES OF INTEREST TO WOMEN 


6:00 P. M. 

Crust of bread or zwieback. 

Warm milk, with white of egg, or cocoa. 

Junket, custard, corn starch, tapioca, or 
farina pudding. 

Drink of water with each meal. 

Paragraph 6 70 

DIET FOR CHILD FROM THREE TO TEN YEARS. 

A child of three years, excepting in rare in¬ 
stances, should not be fed oftener than three times 
a day. The best time for feeding is: Morning meal, 
7 to 8 A.M.; noon meal, 12 to 1 P.M., and evening 
meal, 5:30 to 6:30 P.M. 

In rare instances, fruit or a cup of milk may 
be allowed between the noon and evening meal. In 
the majority of cases five hours are required to 
fully digest the food given. 

The morning meal should consist of a fruit, a 
small dish of cereal with cream, a cup of milk, and 
a piece of toast or crackers. 

The noon meal should consist of a plate of 
soup, a small portion of meat, a small potato, a 
vegetable, bread or crackers, or stale sponge cake, 
water. 

The evening meal should consist of an egg or 
pudding, a cup of cocoa or milk, crackers or bread 
with butter or honey. 

It is safer to give a light meal in the eve¬ 
ning rather than load the stomach with heavy food. 
The American custom of eating dinner at night 
should not be applied to children. 

That milk is very absorptive is well recog¬ 
nized. It is a bad precedent to store it away in 
refrigerators unless it is placed in sealed jars, 
apart from food which exude odor. 

Selection can be made from the following 
diet list: 

• Paragraph 671 
MORNING MEAL. 

Fruit—Raw, stewed, or baked apple; grapes, 
grapefruit, oranges, cherries, peaches, banana, 
stewed prunes. 


Page Two Hundred Fifty-eight 



DISEASES OF CHILDREN 


Cereals—Hominy, oatmeal, farina, force or 
wheat flakes, celery food, shredded wheat, cream of 
wheat, wheaten grit, arrowroot, yellow Indian 
meal, white Indian meal. 

Buttered toast. 

Albert cakes. 

Zwieback. 

Vienna bread and butter. 

Egg in any form. 

Paragraph 672 

NOON MEAL. 

Meat or chicken soup, thickened with len¬ 
tils, peas, split peas, sago, farina, rice or egg. 

Meat—Broiled chop, steak or fish; chicken, 
stewed tripe, sweet-bread, raw scraped beef, roast 
beef, ham or bacon, lamb, bone marrow. 

Baked or mashed potatoes, spinach, peas, 
beans, tomatoes, cauliflower, carrots, asparagus, 
rhubarb, cranberries, or celery. 

Apple cider, buttermilk, kumiss, seltzer, 
lemonade, or very weak tea. 

Stale sponge cake. 

Lady-fingers. 

Nuts. 

Paragraph 673 
EVENING MEAL. 

Crackers and milk. 

Custard. 

Cornstarch pudding. 

Corn muffins. 

Farina pudding. 

Milk toast. 

Tapioca pudding. 

Chicken jelly without wine. 

Calf’ s-foot jelly without wine. 

Junket. 

Oysters. 

Broiled, scrambled, or poached eggs. 

Cream of barley. 

Cream of rice. 

Cocoa and milk. 

Toast or crackers. 


Page Two Hundred Fifty-nine 



LECTURES OF INTEREST TO WOMEN 


Paragraph 674 

PEPTONIZED MILK. 

Contents of 1 peptonizing tube (manufac¬ 
tured by Fairchild Bros. & Foster.) 

1 teacupful cold water, 

1 pint Milk, fresh and cold. 

Put the powder contained in the tube into a 
clean quart bottle, add the cold water and shake 
well; then pour in the milk and again shake the mix¬ 
ture thoroughly. Place the bottle in water of about 
115 degrees F. (or as hot as the whole hand can be 
held in it for one minute without discomfort) , and 
keep the bottle there for twenty minutes. Have the 
water come up on the sides of the bottle or above 
the level of the milk in the bottle. Now take the 
bottle out of the warm water .and place it immedi¬ 
ately on ice. Peptonized Milk should have a 
slightly bitter taste. This bitter taste may be 
overcome to some extent by the addition of sugar. 

Paragraph 675 

OATMEAL WATER. 

3 tablespoonfuls Oatmeal, 

1 quart of cold water, 

A pinch of salt. 

Wash the oatmeal thoroughly. Cook in a 
double boiler for two hours down to one pint, adding 
a little boiling water from time to time. Strain 
through muslin. When strained, add enough boiling 
water to make quantity up to one quart. 

Paragraph 676 

OATMEAL-GRUEL (JELLY). 

3 tablespoonfuls oatmeal (thoroughly 
washed), 

1 quart cold water, 

A pinch of salt. 

Cook in a double boiler for two hours down to 
one pint, adding water from time to time. Strain 
through muslin. 

Paragraph 677 
SCRAPED BEEF. 

A piece of lean round steak is very slightly 
broiled; the browned greased outside portion is 


Page Two Hundred Sixty 



DISEASES OF CHILDREN 


cut away; then with a knife or fork the rare part is 
scraped or shredded. One teaspoonful to one table¬ 
spoonful may be given (well salted) to a child of 
eighteen months. 

Paragraph 678 
PLAIN CUSTARD. 

Yz cupful milk, 

l*yolk of egg, or from Yz to 1 egg, 

1 tablespoonful sugar, 

Yi teaspoonful vanilla, or grating of 
nutmeg. 

Scald the milk. While scalding, beat the 
eggs, add the sugar, mix well. Add the scalded 
milk slowly, stirring all the time. Pour into a 
baking dish, put into a pan of hot water, and bake 
until the custard is firm. Test by inserting the 
point of a knife in the center. If knife blade is 
clean upon withdrawal, the custard is thoroughly 
cooked. 

Paragraph 679 

CHOCOLATE CUSTARD. 

Yz cupful milk, 

1 yolk of egg 
1 tablespoonful sugar, 

1 tablespoonful scraped chocolate . 

Melt the chocolate over hot water. Dilute 
with scalded milk until of the consistency to pour. 
Add the chocolate to the egg, and finish according 
to the general directions given for plain custard. 

Paragraph 680 

BAKED CUSTARD. 

1 egg, 

1 Yz tablespoonful sugar, 

2/3 cupful scalded milk, 

Nutmeg or cinnamon to flavor, 

Small pinch of salt. 

Beat the egg slightly, add the sugar and 
salt. Add hot milk gradually, and pour into small 
buttered moulds. Sprinkle with nutmeg or cinna¬ 
mon, set in a pan of hot water, and bake in a slow 
oven, or until firm. Remove from the mold for 
serving. 


Page Two Hundred Sixty-one 


LECTURES OF INTEREST TO WOMEN 


Paragraph 681 

SAGO PUDDING. 

1 pint of milk, 

1% ounces of sago, 

VA ounces of butter, 

2 eggs, 

1 teaspoonful sugar. 

Cook 1% ounces of well-washed white sago in a 
pint of milk. Stir often to prevent'burning. When 
the sago becomes tender, place it in a dish to cool. 
Add VA ounces of butter and stir until it froths. 

To this, add the yolks of 2 eggs, one after the 
other, 1 teaspoonful of sugar after each egg, and 
lastly whip the whites of the eggs, and stir them 
in. Bake in a well-buttered form with moderate 
heat for three-quarters of an hour. 

Paragraph 682 

CORNSTARCH PUDDING. 

1 pint of milk, 

2 tablespoonfuls cornstarch, 

1 level tablespoonful cane-sugar, 

Flavor to taste. 

With one pint of milk, mix 2 tablespoonfuls 
of cornstarch and one level tablespoonful cane 
sugar. Flavor to taste; then boil the whole eight 
minutes; allow to cool in a mould. 

Paragraph 683 

CUSTARD PUDDING. 

.1 egg, 

1 teaspoonful sugar, 

4 ounces milk, 

1 teaspoonful flour (if desired). 

Break the egg into a teacup and add the sugar, 
beating thoroughly. Add the milk, stir, and then 
tie over the cup a small piece of linen; place the 
cup in a shallow saucepan half full of water, and 
boil for ten minutes. If it is desired to make a 
light batter pudding, a teaspoonful of flour should 
be mixed with the milk before tying up the cup. 

Paragraph 685 

NAVY BEAN SOUP. 

2 ounces (4 tablespoonfuls) navy beans, 

134 pints of water, 


Page Two Hundred Sixty-two 



DISEASES OF CHILDREN 


1 cupful meat broth, 

1 teaspoonful butter, 

1 teaspoonful flour, 

Vz teaspoonful salt, 

Soak two ounces of beans in cold water, drain 
off, and cook them slowly in VA pints of water until 
they are soft but not broken. Rub through a sieve, 
add 1 cupful of meat broth, and cook for one-half 
hour, adding more broth if it boils away. Mix to¬ 
gether 1 teaspoonful of butter, 1 teaspoonful 
flour, and A teaspoonful salt, and add to the soup. 
Return to the fire and cook for a few minutes. 

Paragraph 686 

VEAL AND VEGETABLE BROTH WITH FARINA. 

• 1 pound of veal, 

1 quart of water, 

Cook two to four hours and drain off broth 
1 medium sized potato, 

1 carrot, 

K cupful dry farina, 

A pinch of salt. 

Scrape the vegetables, cut into small 
pieces, and cook in double boiler until tender. 
Strain through a fine strainer, add this to the meat 
broth and reheat. When hot, add K cupful of farina 
and cook for one hour. Season. 

Paragraph 687 

FARINA MILK GRUEL. 

A pint of milk, 

1 tablespoonful farina, 

A pinch of salt. 

Put A pint of milk in double boiler or in a 
saucepan, and heat it to the boiling point over hot 
water. Sprinkle into the milk a tablespoonful of 
dry farina, and cook for twenty minutes, stirring 
frequently. 

Paragraph 688 

POTATO SOUP. 

6 medium-sized potatoes. 
l A pint chopped celery, 

1 slice of onion (if desired). 

1 tablespoonful butter, 


Page Two Hundred Sixty-three 


LECTURES OF INTEREST TO WOMEN 


1 tablespoonful flour, 

VA tablespoonfuls salt, 

1 quart of milk. 

Pare the potatoes and put in a stew-pan with 
the celery and the slice of onion. Cover with 
boiling water and put over a hot fire. Cook thirty 
minutes. Reserve half a cupful of the milk cold and 
bring the rest of the milk to the boiling point in a 
double-boiler. Mix the flour with the cold milk 
and stir into the boiling milk. When the veg¬ 
etables have been cooking thirty minutes, pour off 
the water, saving it to use later. Mash and beat 
the vegetables until fine and light, then gradually 
beat in the water in which they were boiled, rub 
through a puree sieve; put back on the fire. Add 
the salt and whip with an egg-beater for three min¬ 
utes, then gradually beat in the boiling milk. 

Add the butter and serve at once. 

Paragraph 689 

VEGETABLE SOUP. 

M pound lamb, 

1 potato, 

1 carrot, 

2 stalks celery, 

1 tablespoonful pearl barley, 

2 tablespoonfuls rice, 

2 quarts water, 

A pinch of salt. 

Cut the vegetables into small pieces, add 
these with the barley and rice to two quarts of 
water, and boil down to one quart, cooking three 
hours. Add a pinch of salt and strain before 
serving. 

Paragraph 690 

VEAL BROTH FOR DELICATE CHILDREN. 

1 pound of veal, 

1 quart of water, 

A pinch of salt, 

6 teaspoonfuls of cream. 

Veal broth may be made in the usual way, care¬ 
fully skimming off all the fat; 2 drops of cream 
may then be added to each ounce of broth. Sugar 
may be added if indicated. 


Page Two Hundred Sixty-four 



DISEASES OF CHILDREN 


Paragraph 691 

CHICKEN BROTH. 

1 small chicken, or Y* large fowl, 

1 quart of boiling water, 

A pinch of salt. 

Remove the skin and fat from the chicken or 
fowl, and chop bones and all into small pieces. 

Add 1 quart boiling water and the salt. Cover and 
allow to simmer over a slow fire or in a double 
boiler for two hours. After removing from the fire, 
allow to stand for one hour and then strain. 

While cooking, add water if necessary, from time to 
time so that there will be one pint when finished. 


Paragraph 692 

GREEN PEA SOUP. 

1 pint shelled peas, 
lYz pints boiling water, 

.1 quart milk, 

1 slice onion, 

2 tablespoonfqls butter, 

1 tablespoonful flour, 

A pinch of salt. 

Put the peas in a stew-pan with the boiling 
water and a small slice of onion, and cook until 
tender, which will be about thirty minutes. Pour 
off the water, saving for use later. Mash the peas 
fine, then add the water in which they were boiled, 
and rub through a puree sieve. Return to the sauce¬ 
pan, add flour and butter (beaten together) and 
the salt. Now gradually add the milk, which must 
be boiling hot, beat well, and cook ten minutes, 
stirring frequently. 


Paragraph 693 

STEWED PRUNES. 

Vz pound prunes, 

1 pint water, 

1 teaspoonful sugar. 

Stew the prunes until quite soft, and then 
rub them through a coarse sieve. Put this pulp 
back in the water in which the prunes were cooked, 
add the sugar, and boil again for about ten minutes. 


Page Two Hundred Sixty-five 



LECTURES OF INTEREST TO WOMEN 


Paragraph 694 

APPLE SAUCE. 

6 apples, 

1 cupful cold water, 

1 cupful sugar. 

Pare 6 apples and cut them in quarters. 

Place them in an enameled dish, add 1 cupful cold 
water and 1 cupful sugar, and boil about thirty 
minutes. 


Paragraph 695 

BEEF JUICE. 

K to /i pound round steak, 

1 pinch salt, 
or 

1 pound round steak, 

1 pinch salt, 

Cold water to cover. 

Method 1—Broil slightly H to Vi pound round 
steak cut in small pieces, and then press out the 
juice with a meat press or potato ricer, and add a 
pich of salt. Serve fresh, or warm. 

Method 2—Put 1 pound of finely chopped 
round steak in a covered jar, pour in enough cold 
water to cover it, and add a pinch of s'alt. Cover 
the jar and let it stand on ice for six hours or 
more, shaking it from time to time. Strain the con¬ 
tents of the jar through a piece of cheese-cloth. 
When made by this method the beef juice is not quite 
so palatable, although children do not seem to 
object to it, and it has the advantage of being 
more nutritious, and much more economical. 

Beef juice can be warmed slightly by pouring 
it in a small cup, and then placing this in a larger 
one containing warm water. It should, however, 
not be warmed enough to coagulate the albumin. 

Paragraph 696 

LIME WATER. 

1 tablespoonful of slaked lime, 

1 quart of boiled distilled water. 

Put the lime and water in a bottle, cork, and 
shake thoroughly two or three times during the 


Page Two Hundred Sixty-six 







DISEASES OF CHILDREN 


first hour. The lime should then be allowed to 
settle, and after twenty-fur hours the upper clear 
fluid poured off into a glass-stoppered bottle. 
Keep tightly corked and in a cool place. 

Paragraph 697 
WHEY. 

1 quart of milk, 

1 teaspoonful essence of pepsin. 

Curdle 1 quart of new milk at 104 degrees F. 
with Fairchild’s essence of pepsin. Let it stand 
for one-half hour, and by this, time the milk co¬ 
agulates. Then pour the whey off, or hang the 
curdled milk in a straining cloth and let the whey 
drip out. 

Paragraph 698 

JUNKET. 

This is a healthy dessert made simply of 
pure milk and sufficient junket tablet to coagulate 
the milk. It is nutritious and easily digested. 

Milk or cream that has been boiled or steril¬ 
ized cannot be used in making junket, and care 
must be taken not to heat the milk more than luke¬ 
warm, as hot milk spoils the action of the tablet. 

Paragraph 699 

LAMB OR VEAL BROTH. 

1 pound of veal or lamb, 

1 quart of cold water, 

A pinch of salt. 

Chop the meat fine and add to the cold water 
with a pinch of salt; cook slowly for two or three 
hours in a double boiler. Add water, if necessary, 
from time to time, so that when finished there will 
be 1 pint of broth; strain, and when cold, skim off 
the fat. 

Paragraph 700 

ALBUMIN WATER. 

Vt. cup boiled water, 

1 egg (white). 

Pinch of salt. 

Divide the white of one fresh egg by cutting 
it in several- directions with a sharp steel knife. 
Add pint of cold boiled water and a pinch of salt. 
Shake thoroughly and serve cold, either from the 
bottle or a spoon. 


Page Two Hundred Sixty-seven 


LECTURES OF INTEREST TO WOMEN 


Paragraph 701 

NUTRITIOUS ORANGEADE. 

1 egg (white), 

1 teaspoonful sugar, 

Juice of 1 orange, 

5 ounces of water. 

Beat the white of one raw egg with one teg.- 
spoonful of granulated sugar, and add the juice of 
1 orance and 5 ounces of water. Serve cold. 

Paragraph 702 

RICE WATER. 

1 heaping tablespoonful of rice, 

1 pint of water, 

A pinch of salt. 

Wash one heaping tablespoonful of rice, 
soak over night, drain and add a pinch of salt. 

Cook in a double boiler for three or four hours, or 
until the grains of rice are quite soft. Add 
water from time to time to keep the quantity up to 
one pint. Strain through muslin. 

Paragraph 703 
IMPERIAL GRANUM. 

1 or 2 tablespoonfuls Imperial Granum, 

1 pint of water. 

Mix the ingredients, cook thirty minutes, 
and add enough water to make a pint. 

Paragraph 704 

MALTED MILK AND CHOCOLATE. 

2 teaspoonfuls malted milk, 

1 teaspoonful chocolate, 

5 teaspoonfuls cream, 

2/3 cup of hot water. 

Mix the malted milk and chocolate, and add 
cream to make a paste, then add hot water. 

Paragraph 705 

CATNIP TEA. 

1 tablespoonful catnip leaves, 

1 pint of boiling water. 

Pour the boiling water over.the leaves. 


Page Two Hundred Sixty-eight 




DISEASES OF CHILDREN 


allow to steep for five minutes, strain, and serve. 
This is efficient in relieving colic in infants 
when given by mouth or when used as an enema. 

Paragraph 7o6 
SAGE TEA. 

1 teaspoonful of sage leaves, 

1 pint of boiling water. 

Pour the water over the sage leaves, steep 
five minutes, strain and serve. Good in cases of 
flatulence and sometimes allays nausea. 

Paragraph 707 
TOAST WATER. 

2 slices of stale bread, 

1 cupful of boiling water, 

A pinch of salt. 

Cut the stale bread into one-third inch 
cubes, and remove the crusts. Dry thoroughly in a 
slow oven until crisp and a delicate brown. Break 
into crumbs, add the water, cover, and let stand 
one hour. Strain through a cheese cloth, season, 
and serve hot or cold. This often proves efficient 
in cases of nausea. 

Paragraph 708 

SOFT COOKED EGGS. 

1 pint water, 

1 egg. 

Method 1—Put on pint of water in a sauce¬ 
pan. When it boils remove the saucepan to side of 
range, put in one washed egg, and let it stand from 
five to ten minutes, according to consistency de¬ 
sired. Serve in heated egg-cup. 

Method 2—Wash one egg and put in a sauce¬ 
pan with one pint of cold water. Bring to boiling 
point. Remove from water and serve in heated 
egg-cup. 

Paragraph 709 

POACHED EGG. 

1 egg, 

1 slice toast, 

Parsley, 

A pinch of salt. 

Into a shallow pan of boiling water break 


Page Two Hundred Sixty-nine 




LECTURES OF INTEREST TO WOMEN 


one egg. Remove the pan to a place on the range 
where the water will not boil, and let it stand 
until the white is coagulated and a thin film is 
formed over the yolk. Lay a neatly trimmed piece 
of toast on a skimmer, dip it in the hot water to 
soften, place it in the middle of a hot plate, 
remove the egg carefully with the skimmer, and 
place on the toast. 


Paragraph 710 

CODDLED EGG. 

1 egg, 

1 pint water. 

Into a saucepan of boiling water, a fresh egg 
is placed without removing the shell. The water 
is immediately removed from the fire and the egg 
is cooked slowly in it for five minutes. The white 
should then be of jelly-like consistency. 

Paragraph 711 

GRUEL. 

Add two tablespoonfuls of cereal—barley, 
oatmeal, farina, etc.—to a quart of water. Boil 
down to a pint and strain through muslin or cheese 
cloth. 

Paragraph 712 

BOILED CARROTS. 

% pound carrots, 

1 pint meat broth, 

1 teaspoonful breadcrumbs, 

1 teaspoonful butter, 

A pinch of salt. 

Cook V 2 pound of carrots in a pint of fat-free 
meat broth or slightly salted water, adding more 
if it boils away. Rub through a sieve, add 1 tea¬ 
spoonful of bread crumbs, 1 teaspoonful of butter, 
and a pinch of salt. Reheat and serve. 

Paragraph 713 

BOILED BEETS. 

6 young tender beets , 

1 quart of boiling water, 

)i teaspoonful salt, 

2 teaspoonfuls melted butter. 

Cut off the top at least one inch from the 


Page Two Hundred Seventy 


DISEASES OF CHILDREN 


root, as this will prevent the loss of juice in 
cooking. Wash the root carefully without bruising 
it. Cook in boiling salted water until tender. 

This will require from forty-five minutes to one 
hour. Remove the skin, cut into small slices or 
squares, and serve plain or with a small amount of 
melted butter. These may be added to the diet of a 
a child five years (or more) of age. 


Paragraph 714 

CREAM OR WHITE SAUCE. 

(To pour over any vegetable.) 

Yz cupful milk or thin cream, 

Yz tablespoonful butter, 

Ya saltspoonful salt, 

Yz tablespoonful flour. 

Scald the milk. Melt the butter in a sauce¬ 
pan, remove from the stove, add the flour, then 
gradually the scalded milk, place in a double 
boiler over the fire and cook, stirring constantly 
until smooth. 


Paragraph 715 

EGG POACHED IN MILK. 

1 egg, 

lYz teaspoonfuls butter, 

Yz cupful milk or thin cream, 

A pinch of salt, 

1 slice of toast. 

Melt the butter in the top of the double 
boiler, add the milk or thin cream, and when hot 
carefully drop in the egg. Cook until the white is 
nearly firm, keeping it just below the boiling 
point. Add the salt and serve on toast. 

Paragraph 716 

STEWED TOMATOES. 

2 tomatoes, 

1 ounce cracker crumbs, 

1 teaspoonful butter, 

Ya teaspoonful salt, 

Yz teaspoonful sugar. 

Pour boiling water over the tomatoes, peel, 
stew for twenty minutes, stirring occasionally. 


Page Two Hundred Seventy-one 



LECTURES OF INTEREST TO WOMEN 


Add a few bread crumbs or crackers and season with 
salt and butter. A small amount of sugar may be 
added if the tomatoes are very acid. 

Paragraph 71 7 

SQUASH. 

1 small squash, 

1 pint water, 

H teaspoonful of salt, 

1 teaspoonful butter. 

The various varieties of the summer squash 
are generally cooked when so small and tender that 
the thumb-nail can easily pierce the rind. 

To prepare for the table, wash the squash, 
remove the rind, cut into smalL pieces, and either 
cook in boiling water or steam. It will cook in 
boiling water in thirty minutes, while about an 
hour is required if cooked in the steamer. The 
cooked squash is mashed fine, and seasoned with 
salt and butter. This method gives a delicately 
flavored dish. 

Paragraph 718 

ORANGE GELATIN.FOR OLDER CHILDREN. 

Vz box shredded gelatin, 

Vz cupful cold water, 

Juice of 1 lemon, 

2 cupfuls boiling water, 

1 cupful sugar, 

1 cupful orange juice. 

Soak the gelatin in the cold water thirty 
minutes. Add the boiling water and dissolve. 

Then add sugar and fruit juice, strain through a 
fine strainer (or a cloth) into molds, and set away 
to .harden. 

Paragraph 719 

PRUNE JUICE. 

Vz pound prunes, 

1 tablespoonful sugar. 

Wash thoroughly Yz pound of prunes, cover 
with cold water, and soak over night. In the morn¬ 
ing, place on the stove in the same water, and cook 
until tender, add 1 tablespoonful of sugar and 
strain. 


Page Two Hundred Seventy-two 



DISEASES OF CHILDREN 


Paragraph 720 
PRUNE GELATIN. 

1 pound prunes, 

1 quart water, 
l A box gelatin, 

1 cupful sugar. 

Place the prunes in a quart of water and 
cook slowly until tender. Remove from stove, drain 
off the liquid, set aside. Remove the stones from 
the prunes and push the pulp through a sieve. Add 
the pulp to the liquid, and bring the whole to a 
boil again. Pour this boiling mixture on % box of 
gelatine which has been previously soaked in cold 
water. Add the sugar and stir to dissolve. Strain 
and allow to stand until firm. 



Page Two Hundred Seventy-three 














, 

• - - 9 






























N 




















































. 






































































PART IV. 


Part IV contains a miscellaneous 
selection of articles pertaining to the 
training and care of children. These 
special subjects fulfil every require¬ 
ment, and gives the mother complete in¬ 
structions on all important rules for 
nursing; such as, the administration of 
drugs, making and applying local applica 
tions, medical treatment for common and 
special diseases, the administration of 
food, accidents and habits relative to 
children; in fact, it gives everything re 
quired to work in harmony with Part I., II 
and III, together with many s-pecial sub¬ 
jects of vital importance for the mother 
to know. 










V 


I 




V 









THE TRAINING OF INFANTS 
AND CHILDREN 


Paragraph 721 

The responsibility of the mother or nurse in 
giving the infant or child proper training cannot 
be over estimated. As we have said, they are cre¬ 
atures of habit, and the wrong habit once formed 
oftentimes requires months to make it right. So 
begin right, and start early in life with the 
infant, then the task is not a difficult one. 

During the first six months do not try to 
amuse the baby, or give it toys to play with, as it 
will only make it fretful and disturb its sleep 
and rest. After five or six months supply it with 
toys that make a noise. At this age infants enjoy 
animals, dolls, blocks, beads, and various little 
trinkets painted in bright colors. 

After the child is two or three years old, 
furnish it with a playground containing swings, 
tents, play-house, and sand-pile. It will give the 
child much pleasure, as it will spend a great deal 
of time in play. Remember that part of a child’s 
training is teaching it to play, because it comes 
natural to the child, and should be encouraged. 

Many mothers and nurses spend a great deal 
of time in trying to teach babies to do things that 
are far beyond their age and ability. Let the 
infant take its.time to develop. Let it creep when 
it gets ready to creep; let it walk when it desires 
to do so, and the same with talking—do not try to 
teach a baby to talk too early because it will learn 
when the proper time comes. As we have said, there 
is no set time when each individual infant is going 
to creep, walk or talk. Remember and give the 
child time for physical development, and do not 
overtax its mental facilities. 

Paragraph 722 

Great care should be exercised in regard to 
word or action before children—let us impress 


Page Two Hundred Seventy-seven 



LECTURES OF INTEREST TO WOMEN 


upon you this important point—because they are 
wonderful imitators and learn from example. 

Mothers, fathers, or nurses must expect a child to 
do and say what they do. Remember that continuous 
example conveyed by habits moulds the character 
of the child. Therefore, you should remember that 
example is one of the most forcible and lasting 
instructors. Whatever the child sees you do, it 
will imitate, and will say what you do, doing so 
unconsciously. 


Paragraph 723 

A child will grow up and become like those 
with whom they are daily associates, and the ex¬ 
amples that are set forth in domestic training does 
more in influencing that little individual in form¬ 
ing the moral character of the future men and 
women than any education that it may receive in 
school or college. Trivial matters, as they may 
seem, become of great importance to the little one, 
and contributes much to its character for better 
or worse. 

Let it be remembered that the acts and deeds 
done by the parents often remain with the child 
through life, and. the acts of affection, discip¬ 
line, and self-control are the things that count 
in developing the character of the child, because 
those things are going to remain with it. All else 
which it may learn may be forgotten, but not the ex¬ 
amples taught by mother, father, or nurse. 


Paragraph 724 

In training a child right from wrong, harsh 
punishment has no place. A child knows nothing 
about right and wrong, and follows its natural in¬ 
clinations. If these inclinations lead the child 
in the wrong direction, then it is the parents’ duty 
to guide it into another and better one. Divert its 
energies in a wholesome and normal direction. This 
is true in the training of infants and children of 
all ages. We so often see parents who believe in 
forcing with penalties to the point of cruelty in 
teaching children right from wrong. They forget 
that a child is endowed with all the desires, in- 


Page Two Hundred Seventy-eight 



TRAINING OF INFANTS AND CHILDREN 


clinations and tendencies that they have them¬ 
selves. Remember that a few kind words will do 
more good than a dozen punishments. 

Paragraph 725 

An infant should be taught, the first few 
months, the law of obedience, and authority alone 
should govern a child because it is not capable of 
reasoning, and argument accomplishes nothing. 

A child must be taught to obey. It must, or it must 
not do certain things. Govern children with love, 
not with the rod, and if children are taught real 
love for their parents, they will obey them, whose 
word should be law. Here the mother must use a 
great deal of tact and reasoning. Do not put too 
many ‘‘Don’ts’’ before a child. 

Paragraph 726 

Be sure and weigh all conditions well before 
any threats of punishment are made, in order to 
govern the child, but when once made, punishment 
should be administered right after the offense, but 
never in anger. If a child disobeys, and has been 
told it will be punished if it does disobey, then 
see that these rules are followed out to the letter. 
If the punishment was to be that the child was to 
be put to bed, or remain in the house for the rest of 
the day, required to stand in the corner, or what- 
it may be, do not fail to see that the child does 
exactly what it has been promised if it disobeys. 

If there is good management on the part of the 
nurse or mother in the early life of the little in¬ 
dividual, there will be very few punishments, and 
the child will be obedient. If you want a child 
to do a certain thing, do not tell it a falsehood 
in order to accomplish your aim. Be truthful at all 
times to children, and never make a promise to them 
that you do not fulfill. 

Paragraph 727 

Early in life, as early as two or three 
years old, the child should be taught to think and 
do for others. As a rule children are selfish and 
this is perhaps the hardest lesson they are required 


Page Two Hundred Seventy-nine 



LECTURES OF INTEREST TO WOMEN 


to learn, especially giving up their playthings 
to other children, or to divide its pleasures with 
others. Yet the child should be taught thought¬ 
fulness, gentleness, kindness, love and sympathy 
for its playmates. It should associate with chil¬ 
dren whose habits are good. Give the child suffi¬ 
cient time and attention to teach it not to be 
selfish. Arrange to allow it to have some re¬ 
sponsibility or care of some playmate, or a pet 
of some kind—something for it to care for—as 
this will be the best means to accomplish this end. 

Some children are more boisterous than others, 
and naturally are inclined to be noisy during play. 
When necessary, they can be taught that they can 
get just as much pleasure out of play by being 
reasonably quiet as they can by making undue noise. 

Paragraph 728 

While talking about the training of children, 
let us mention a very important point, and that is 
‘‘fear.’’ Never frighten a child, or let a child 
be frightened. Teach a child to have no fear of 
animals, and that there is nothing more in the dark 
than there is in daylight. Discard all the ghost 
and 4 ‘boogie man’’ stories; never mention such 
things to little children. 

Never say to a child, ‘‘If you don’t do so and 
so I will send for the Doctor and have him cut 
your ear off,’’ or something of that sort. So many 
times parents turn the child against physicians by 
making such remarks, and in case they do require 
medical attention, the doctor can never examine 
them or treat them intelligently, and the mother is 
to blame. Children should be taught that the 
doctor is their best friend. 

Paragraph 729 

The society that a child should enjoy should 
be very limited until it is at least 18 months to 2 
years old. Up to that time it should see just enough 
people to teach it not to be in fear of strangers. 
Even after that age, the presenting of children to 
visitors only has a tendency to develop a forward 
child who continually shows off before strangers 
or visitors. This should be guarded against. 


Page Two Hundred Eighty 




TRAINING OF INFANTS AND CHILDREN 


Paragraph 730 

In conversing before children, great care 
should be taken as to the remarks made in regard to 
them, because it is surprising how well they in¬ 
terpret conversation. A child should be taken out 
by its parents to visit cafes, theatres, parks,, 
etc., and let it mingle with people and see how 
others do. It broadens the child’s ideas, and gives 
it a force of character that will last a life time. 
All this should be done with great care and judg¬ 
ment upon the part of the parents. 


Paragraph 731 

The school life of every child is of great 
importance, as it is during these years that a child 
develops and forms the character of associates 
together with its home training, which means for 
better or worse. It requires a great deal of care 
to be exercised to guide a child through these im¬ 
portant years. Do not send a child to school too 
young simply to have it somewhere out of the way, so 
to speak. 

Remember we have just said that the home life 
molds the character of the little one, and that is 
why it should get its first lessons there, so that 
home influences should remain with it the rest of 
its life. It is impossible, and not intended, that 
institutions of learning should so thoroughly in¬ 
fluence the character and general actions and 
intellect of the child as well as it can be received 
at home. 


Paragraph 732 

We do not believe in the kindergarten being 
used for real young children. Let the child first 
get its physical condition normally. Do hot 
destroy the nervous system by calling upon the 
little one for too much mental work. What differ¬ 
ence does it make at what age the child learns to 
read. One child may be developed sufficiently to 
accumulate sufficient knowledge to be able to read 
at seven years and others at nine. 

Do not let a child have books too early— 
develop the body first. It is better to teach it to 


Page Two Hundred Eighty-one 



LECTURES OF INTEREST TO WOMEN 


play than to teach it to read, as is often the case 
When a child is seven or eight years of age, it is 
plenty of time to give it some actual work to do 
(that is study), and at that age the time should 
be short. Two or three hours a day is sufficient, 
but even the mental training should not be at the 
expense of the physical. In other words, look 
after the child’s health. 

Paragraph 733 

We believe, at the present day, the schools 
require too much mental work for children with 
growing brains. When they begin school life they 
should not study at home; give that time to play 
and outdoor exercise. Build up the physical part of 
the child, both in boys and girls. The general 
health of the child and care of the eyes during 
school work should not be overlooked, because many 
children attending school have weak-eyes, and they 
are often neglected. Children with any eye trouble 
should be examined by an eye specialist. School 
instructors should realize these facts, and they 
should take every precaution to care for the child’s 
health. It is the mother’s and father’s duty to see 
that this is accomplished. 

Paragraph 734 

Great care should be taken of the child’s diet 
while attending school. See that it gets the right 
combination of food. The child should eat reg¬ 
ularly and, when possible, should have warm meals 
at lunch time instead of eating cold lunches. 

When you take into consideration the 
physical, as well as the mental training of the 
child, you have a great responsibility, and one 
that requires a great deal of care and attention on 
the part of the nurse or mother, and you should 
become familiar with this most important subject. 

Paragraph 735 

THE HEALTHY INFANT. A great many children 
are born healthy regardless of the mother’s health. 
Take a woman who has consumption, heart disease, or 
starvation; children born of such mothers, we in¬ 
variably find, are very healthy, yet the mother is 


Page Two Hundred Eighty-two 




TRAINING OF INFANTS AND CHILDREN 


in a dying condition. Yon may take the slums of our 
great cities, where women live and exist under the 
most abnormal conditions, their babies are fat and 
chubby. Nature seems to give them a good start, and 
if they had the proper care they would do well, but 
the danger comes when they have to struggle with 
the difficulties of civilization. 

Paragraph 736 

A healthy baby eats, sleeps, and does not cry 
frequently or long; has normal bowel movements two 
or three times a day; stools are soft and yellow, 
never green, nor should they contain any white 
curds. Temperature should be normal; that is, not 
over 100 degrees per rectum. The pulse is variable. 
The skin is clear and without any spots or rash of 
any kind. The tongue and mouth are clean, without 
even one patch of white. 

Paragraph 737 

A healthy baby increases in weight about 
seven ounces a week for the first three months, with 
the exception of the first week. You will notice 
this gain more regular in breast-fed babies than 
you will in bottle fed. In the latter the growth is 
more uncertain, about four ounces a week. The 
forehead should not be damp, nor should the baby 
sweat in its cot. If it does you will generally find 
that it is covered with too heavy clothing. We have 
noticed that babies fed continually on Eagle Brand 
Milk always sweat more freely. Most likely this 
condition is due to the tissues being full of water. 

Paragraph 738 

Now remember this, that the anterior fontanel 
(the soft spot on top of the head) is an excellent 
guide to tell the normal condition of the baby’s 
health. When it is level with the bones you can be 
reasonably certain that you have a healthy baby. 

If it is depressed and sunken below the level, the 
child is in ill health. Sometimes in meningitis, 
and possibly before the baby has convulsions, the 
fontanel rises above the normal level of the bones, 
or it bulges. So when you are in doubt as to whether 
a baby is sick or well, take all these things into 
account and it will assist you greatly. 


Page Two Hundred Eighty-three 


LECTURES OF INTEREST TO WOMEN 


Paragraph 739 

DON’TS. 

DON’T feed the baby too often or too much. 

DON’T let a baby be over twenty minutes at the 
breast or bottle at one feeding. 

DON’T let a baby have an empty bottle to suck. 

DON’T give it a pacifier, mother’s comfort, 
or any such device for keeping it quiet. It will 
not need them if properly cared for and fed. 

DON’T let it suck its thumb. It spoils the 
shape of the mouth. 

DON’T let it go even a day without a drink of 
water. Give a teaspoonful occasionally. 

DON’T let it sit on -the floor on cold days, 
especially if there is no carpet, unless there is a 
blanket or pad under it. 

DON’T let it sit in front of an open window, 
with the air blowing on it. 

DON’T let it sit in a draft between open 
window and door. 

DON’T let it play with matches, pins, scis¬ 
sors or sharp-pointed objects. 

DON’T urge it to stand on its feet too young. 
If you do it may become bow-legged. 

DON’T give it solid food before one year, and 
then sparingly. 

DON’T give it candy, chocolate or sweet 
things. 

DON’T let it lie in a wet napkin. 

DON’T use a soiled napkin the second time 
before washing it. 

DON’T let the hands and feet get cold. 

DON’T give it tea or coffee, beer, whiskey, 
gin or any drink containing alcohol. 

DON’T neglect giving the baby a tub bath 
every day. 

DON’T forget to leave the windows open day 
and night. 


Page Two Hundred Eighty-four 


TRAINING OF INFANTS AND CHILDREN 


DON’T allow a child to take vigorous exercise 
after meals. 

DON’T allow a child to sleep with anyone. 

Let it sleep alone as much as possible. 

DON’T lay a child on a feather pillow. Lay it 
on a firm bed. 

DON’T give soothing syrup to make the baby 

quiet. 

DON’T neglect to keep a child’s mouth and 
teeth clean. This furnishes the best protection 
against disease. 

DON’T give a child drugs for its appetite, 
until all other means have failed. 

DON’T feed a child candy, cake, crackers, 
etc., between meals. 

DON’T feed all children of the same age 
alike, be governed according to size and health. 

DON’T let the good women of the neighborhood 
tell you what disease your child is suffering from, 
and how to treat it. 

DON’T belittle the gravity of a sore throat; 
give it careful attention at the beginning, and 
medical aid if necessary. 

DON’T put well children with sick ones so that 
they may catch the disease and be over with it. 

DON’T let your children play with cats and 
dogs that are in the habit of running about. It is 
best to bar them altogether as they carry disease. 


Paragraph 740 

BABY’S BASKET. It should contain the following 
articles: Alcohol for dressing the cord; plain ab¬ 
sorbent cotton for washing the mouth and eyes; blunt- 
pointed scissors; safety-pins of assorted sizes; a 
baby’s soft hair-brush; a small fine comb; a powder 
box containing powder and puff; soap in a metal or 
celluloid soap-box; a fine soft sponge, and a soft 
wash-rag; vaseline in a jar or tube; a soft blanket in 
which to receive the child after birth; a woolen shawl 
or shoulder blanket; a complete suit of clothes. 


Page Two Hundred Eighty-five 



LECTURES OF INTEREST TO WOMEN 


Paragraph 741 

LONG CLOTHES. The following list of clothing 
(the layette, as it is commonly called) may be con¬ 
sidered one of average size: 

Flannel binders . 3 

Knitted bands ..—. 3 

Diapers (two sizes) . 4 doz. or more 

Shirts . 6 

Petticoats (flannel) . 4 

Petticoats (cambric if 

desired . 4 

Slips . 4 

Socks . 6 pair 

Night - gowns . 6 

Wrappers . 2 

Sacks, knitted. 2 

Cloak . 1 

Hood ... 1 

Mittens . 2 pairs 

Veils . 2 

Shoulder blankets ^. 2 

Paragraph 742 

SHORT CLOTHES. The following list may serve 
as a guide to the number of garments needed for short 
clothes: 

Knitted binders. 4 

Diapers .. 4 doz. 

Shirts, close fitting. 6 

Petticoats (flannel) . 4 

Petticoats (cambric if desired) 4 

Dresses . 8 to 12 

Stockings . 8 to 12 pairs 

Shoes . 2 pairs 

Drawers (if desired) . 8 to 12 pairs 

Creeping aprons. 2 

Wrappers. 3 

Sacks ... 3 

Bibs .12 

Night-gowns . 6 

Cloak or Coat. 1 

Hood or Cap. 1 

Leggins . 1 pair 

Veils • . 2 

Mittens . 2 pairs 


Page Two Hundred Eighty-six 





































TRAINING OF INFANTS AND CHILDREN 


Paragraph 743 

TIME FOR CHANGING. The time for changing 
from the clothing of infancy to that of childhood 
depends not so much upon the age as upon the time 
when the baby learns to do without a diaper. 

Paragraph 744 

WHEN A BABY SHOULD BE PUT IN A HIGH CHAIR. Do 
not allow a baby to sit in a high chair until it is 
old enough to be able to hold its head and spine 
erect. It should never be left in a high chair for 
any length of time because there is danger of 
causing deformity by forcing the child to sit in a 
rigid position before the bones and muscles are 
sufficiently strong to stand it. 

Paragraph 745 

HOW TO LIFT A BABY. The spine should always 
be supported in handling a baby. Slip the left hand 
under the back, underneath the shoulders, in such 
a way as to give the neck and head support. Place 
the other hand under the buttocks. Never lift a 
child without supporting it in this way. Do not 
place the hands under the arm pits, or attempt to 
lift it in that manner without any support. Also 
never try to lift the baby by the arms. 

Paragraph 746 

INFANT CREEPS. An infant begins to creep at 
the age of seven or eight months, on its hands and 
knees, and by nine or ten months it is often able 
to stand with support, and frequently to walk some 
steps by holding on to the furniture or someone’s 
hand. At the age of one year, strong children can 
walk a little without help. 

There is no absolute rule, however, for the 
time, or for the exact order of learning to creep 
and to walk. Many children are very slow in walk¬ 
ing, particularly if they have become expert and 
rapid crawlers, while some do not creep at all, but 
learn to stand first and then to walk. Some creep 
only on the hands and feet, never using the knees; 
others never creep but progress over the floor with 
a peculiar pushing movement while in a sitting 
position. 


Page Two Hundred Eighty-seven 



LECTURES OF INTEREST TO WOMEN 


Paragraph 747 

LENGTH OF INFANT. As to the length of a baby, we 
are struck by the fact that from the age of two to that 
of four months, the increase is one incb a month, and 
after this, up to one year, it is half an inch a month. 
The average length of an infant at birth is about 20 
inches. 

Paragraph 748 

INCREASE IN WEIGHT. During the first three 
weeks of the first month, the baby’s gain in weight 
will average about one ounce a day; in the second 
month, about one ounce a day, and in the third and 
fourth months about five and one-half ounces a week; 
that is, about three-quarters of an ounce a day. By 
the time it is five months old it has doubled its orig¬ 
inal weight. In the fifth and sixth months it in¬ 
creases two-thirds of an ounce a day, and after this, 
from seven to twelve months, it gains at the rate of 
about one pound a month; that is, three and two-thirds 
ounces a week, or a trifle over a half ounce a day, ex¬ 
cept in the ninth and again in the eleventh month, 
when the increase in weight often lessens somewhat. 
At the age of one year the baby has trebled its original 
weight at birth. 

Paragraph 749 

SUCCESSFUL NURSING. 

The chief signs of successful nursing are 
when a child is gaining not less than four ounces 
a week; after the baby nurses, it seems satisfied 
and will go so sleep without fussing or crying, and 
seems perfectly contented until the next nursing 
period; the stools are normal, and bowel move¬ 
ments occur two or three times daily. 

Paragraph 750 

UNSUCCESSFUL NURSING. 

The most important signs of unsuccessful 
nursing are when the gain in weight is less than 
four ounces a week; the infant wants to nurse longer 
than the regular time, cries if removed from the 
breast, is not satisfied, very restless, and begins 
to cry before the next regular nursing period; 
the stools generally contain curds; there may be 
diarrhea or constipation; more or less colic, and 
they suffer a great deal with gas in the stomach. 


Page Two Hundred Eighty-eight 


TRAINING OF INFANTS AND CHILDREN 


Paragraph 751 

A NURSING MOTHER FREE FROM WORRY. 

A nursing mother should be free from all 
worry, anxiety and nervous excitement, because 
such a condition has a marked influence upon the 
breast milk, and renders it poisonous, so to speak. 
She requires sufficient exercise, plenty of fresh 
air, the necessary amount of rest, and should be 
free from all worry in order to maintain the normal 
condition of the breast milk. 

Paragraph 752 
INCORRECT DIET. 

1. When baby seems alright, but it does not 
seem to gain in weight,- increase its food. If there 
is still no gain in weight, strengthen its food in 
quality. 

2. When baby is hungry, it cries, sucks its 
fingers, sleeps poorly, etc. Increase its food— 
first in quantity and then in quality. 

3. When baby vomits immediately after being 
fed, it has been fed too much in quantity, or it has 
been ‘‘bounced about’’ too soon after being fed. 
Milk mixture may be too strong. 

4. When baby regurgitates sour milk between 
its feedings, the feeding contains too much cream, 
or milk mixture may be too strong. 

5. When baby has colic after feeding, the 
food is too strong. Dilute the feedings more. 

6. When baby is teething, has any fever, or 
does not feel well, the feedings should always be 
diluted, and in some instances to half strength. 

7. When baby has no appetite, diminish the 
strength of food. 

Paragraph 753 

HABITUAL LOSS OF APPETITE. 

The growing child requires not only suffi¬ 
cient nourishment to sustain life, but it must also 
have enough to meet the demand for the increased 
growth; that is, it requires more food than the in¬ 
dividual who has reached maturity. The young child 
is naturally a very hungry individual, and the re¬ 
quired amount of food to sustain life, as well as to 
increase growth, is very essential. 


Page Two Hundred Eighty-nine 



LECTURES OF INTEREST TO WOMEN 


When a child has habitual loss of appetite, 
and the condition of its health is abnormal, we 
must discover the cause and apply the proper remedy. 
A child suffering from a loss of appetite does not 
seem sick; it may be active and playful; sleeps 
normally; but it tires easily, and must be coaxed 
to eat. 

Oftentimes children with poor appetites will 
give history of excessive milk drinking. The child 
will take several glasses of milk during the day 
and refuse all other food. Such a child, in all prob¬ 
ability, was fed on milk exclusively for the first 
two years of life. These children will invariably 
show evidence of malnutrition. They are generally 
pale and sallow, with flabby muscles. Oftentimes 
the lack of appetite is due to a prolonged exclusive 
milk diet. It is for this reason that we refer to 
the danger of an exclusive milk diet in the treat¬ 
ment of typhoid fever. 

Another cause of the loss of appetite is too 
frequent feeding. We often see children fed six or 
seven times in the twenty-four hours. Some parents 
think because a child takes a small amount of food, 
it should take it often, but the fact is, more and 
stronger food should be given at regular intervals. 

Another very injurious habit that will cause 
loss of appetite, is eating between meals. Giving 
a child candy, cake, crackers, and fruit, also 
poorly cooked and prepared food (the kind generally 
eaten by an adult) , will cause it to suffer from loss 
of appetite. Children living in flats and confined 
indoors a greater part of the time, as a rule, 
suffer from loss of appetite. Constipation is also 
another cause that may be added to the list. 

Paragraph 754 

TREATMENT. It is a mistake, when a child be¬ 
gins to lose its appetite, to give it drugs. The 
only medication that should be permitted is some 
simple laxative, like Phillips’ Milks of Magnesia, 
1 to 3 teaspoonfuls at bedtime. Every child should 
spend (when the weather will permit it) at least 
five-hours each day in the open air, and in stormy 
weather it should have a play-room with perfect 
ventilation. 


Page Two Hundred Ninety 



TRAINING OF INFANTS AND CHILDREN 


The next important step in the treatment is 
in the regulation of the feeding hours. After a 
child is running about, it should not be fed oftener 
than four meals during the twenty-four hours, and 
after the second year, only three meals a day should 
be given. All feedings should be given at a definite 
time each day. This is absolutely necessary, and 
nothing whatever should be allowed between meals, 
excepting drinking water. 

In order to get the best results in increasing 
the diet, it is best not to give the full amount of 
food to start with, but place the child temporarily 
on a markedly reduced diet. Do not give any meat, 
eggs, bread-stuffs, vegetables, or fruits. At 
first, give milk, gruels, and broths. If it is a 
case in which the giving of milk has caused the 
loss of appetite, then no milk should be given, but 
the diet should consist of broths, thin gruels, 
dry bread, zwieback, etc. This should be kept up 
for about two days. 

Oftentimes the child will become very hun¬ 
gry, then freer feeding is allowed, but under the 
same strict regularity as to time, and no feeding 
between meals. If these instructions are carried 
out to the letter, you will rarely find a case of 
habitual loss of appetite which will not respond 
to this simple method of treatment. 

Sometimes the diet will not improve under 
such dietetic and hygienic measures as we have just 
given, and in that case a change of climate, in ad¬ 
dition to the proper methods of feeding, will be of 
value; that is, a change from the city to the coun¬ 
try, or from the country to the seashore. When 
such patients cannot make the climatic change, then 
we must arrange, as best we can, the hygienic sur¬ 
roundings to suit the individual case'. 

When hygienic, dietetic, or climatic treat¬ 
ment fails to increase the appetite, we have a few 
simple remedies of value, which may be used, espe¬ 
cially in cases where it is impossible to have the 
climatic changes. For a child over eighteen months 
of age, give 1 grain of citrate of iron and 1 grain 


Page Two Hundred Ninety-one 



LECTURES OF INTEREST TO WOMEN 


of muriate of quinin, dissolved in half a teaspoon¬ 
ful of sherry wine. This should be given, well di¬ 
luted, before meals. For younger children, half a 
grain of the iron and quinin may be given in half a 
dram of sherry wine well diluted, before meals. 

If this treatment is not successful for a 
child over fifteen months old, and under two years, 
give 1 minim of dilute hydrochloric acid and a half 
minim of the tincture of nux vomica in 2 teaspoon¬ 
fuls of water; after the second year, 2 minims of 
the diluted hydrochloric acid and 1 minim of the 
tincture of nux vomica in 3 teaspoonfuls of water. 
In either case it should be given before meals. 

Paragraph 755 

THE HYGIENE OF FEEDING. We have told you 
the kinds of food a child should have, and when it 
should be fed, but how it should be fed is entirely 
a different subject. A child should never sit at 
the table with adults until it can have adult diet. 
If possible, it should dine alone, or with other 
children. It is wrong to expect a hungry child of 
tender age to sit at a table and see and smell the 
fragrant dishes and not be allowed to partake of 
such food, but be forced to content itself, without 
complaint, with its restricted diet. This is not 
right, and it causes many tears, disputes, and en¬ 
counters between parent and child, and today we see 
too much of this form a part of the daily routine 
of the life of childhood. 

A child should be taught to use its spoon and 
fork when it begins to feed itself, but do not allow 
the fork or spoon to come in contact with anything 
but the food and child’s mouth. Under no circum¬ 
stances, should a feeding utensil be allowed to 
come in contact with the lips of the nurse or 
mother. How often do we see mothers, or even 
nurses, sip the first teaspoonful of food which is 
to be given to the child, to determine if it is the 
proper temperature, using the spoon to feed the 
child immediately afterwards. At other times, in 
order to get a child to eat, the mother will place 
the spoon in her own mouth as if intending to take 
it herself. Or she will remove from the spoon, with 


Page Two Hundred Ninety-two 


TRAINING OF INFANTS AND CHILDREN 


her own lips, adhering particles of food. Any one 
of the many forms of bacteria may thus be readily 
transferred to the mouth of the child. 

It is unquestionably a means of infection 
from the mouth, due to decayed teeth, tuberculosis, 
diphtheria or syphilis. The germs of tuberculosis 
and diphtheria are often found in the mouths of 
perfectly healthy adults. They cause no symptoms 
of disease, because the normal power of resistance 
of adults is able to overcome the infection, but 
such is not true of the child. Its resisting powers 
are very slight, and when these germs are carried 
to the delicate mucous membrane of the infant’s 
mouth and throat, they thrive actively. The child 
develops diphtheria or tuberculosis, and the 
mother grieves and wonders how the child could have 
contracted such a disease. It may die and the mother 
will not know that she herself, infected the child, 
and caused its death. 

Paragraph 756 

RECTAL FEEDING. 

Nutrient enemas are necessary in cases where 
the stomach does not retain food, and the strength 
of the patient must be supported by taking the re¬ 
quired amount of nourishment. Various kinds of 
food may be administered per rectum with some degree 
of success. It requires proper technic in order 
to get results, and it is necessary that the physi¬ 
cian himself should see that the technic is prop¬ 
erly carried out. When this is done, it is consid¬ 
ered by good authority that one-fourth of the 
nutriment needed by the body can be absorbed by 
the rectum. The patient may not only be sustained 
by this method of feeding for several days, but 
can be kept alive for several weeks by exclusive 
rectal feeding; but when the technic is not prop¬ 
erly carried out, and the rectum becomes irritated, 
the treatment is of little or no benefit. 

The articles required to give a nutrient 
enema are a fountain syringe, or a funnel, with a 
soft rubber catheter attached, rubber sheeting or 
bed-pan; older children may need a hard rubber 
piston syringe. 


Page Two Hundred Ninety-three 




LECTURES OF INTEREST TO WOMEN 


Paragraph 757 

TECHNIC. To give a nutrient enema properly, 
the rectum should first be thoroughly cleansed by 
administering a high injection of normal salt solu¬ 
tion one hour before enema is to be given. This 
cleansing should be done at least once a day, and 
if much mucous is present v it is of great advantage 
to precede each feeding with a cleansing enema. 

If for any reason the rectum becomes inflamed, then 
boracic acid may be used instead of the salt solu¬ 
tion, or bicarbonate of soda solution may be used. 
The strength required is 1 te.aspoonful of either 
the boracic acid or bicarbonate of soda to a pint of 
water. 

A very convenient way to cleanse the lower 
bowel is to use the return-flow catheter. In this 
way, several quarts of the solution may be used, 
when necessary, in marked catarrhal conditions, or 
when there is a great deal of mucous present. The 
temperature of the cleansing enema should be about 
96 or 98 degrees F., the temperature of the enema 
to be retained, between 90 and 95 degrees. When 
the solution is too cold or too hot, it will not be 
retained. The patient should lie on the left side 
with the hips well elevated, at least four inches 
higher than the shoulders, and the funnel or foun¬ 
tain syringe should be between three or four feet 
higher than the child’s body. 

Paragraph 758 

The rectal tube, or large size catheter with 
walls reasonably thick should be used, the size 
used according to the individual; that is the adult 
requires a much larger tube than a child. The tube 
used for children should be in proportion to their 
age; much smaller than the one used for adults. A 
No. 18 American soft rubber catheter is the correct 
size to use for a child 7 to 10 years old. It should 
be thoroughly lubricated with vaseline, and 
introduced into the rectum by twisting slightly. If 
it is not passed easily a small amount of the liquid 
should be passed in, which should balloon out the 
rectum, after which the tube may be passed with 
ease eight or ten inches. The tube should be intro- 


Page Two Hundred Ninety-four 



TRAINING OF INFANTS AND CHILDREN 


duced as high as possible, because the absorption 
from the rectum is very little. The food should 
be allowed to pass quickly from a funnel or fountain 
syringe. Care should be taken not to allow any 
air to be injected with the fluid. It is as im¬ 
portant to cover the anus with vaseline as it is to 
lubricate the tube. 

After the injection, the patient should lie 
as quietly as possible for at least an hour and be 
instructed to try to retain the nutrient enema. A 
pad of gauze or a towel should be pressed over the 
anus for some time (20 minutes to a half hour) , and 
the patient’s mind, through suggestions along other 
lines, should be diverted from the subject. After 
a few feedings, the bowels become accustomed to 
the injections, and they are retained without dif¬ 
ficulty. 

When an enema is expelled immediately after 
it is given, it should be repeated in a very short 
time; that is, within ten or fifteen minutes, be¬ 
cause when an enema is not retained, it is no sign 
that the next one will be expelled. 

Paragraph 759 

In older children, there may be more or less 
bearing down or straining, and to overcome this, 
use an ordinary hard rubber or glass piston syringe 
of sufficient size, with catheter attached. This 
kind of a syringe will provide sufficient force to 
overcome the pressure exerted by the abdominal 
muscles. 

The amount to be given at one time is very im¬ 
portant; it should not be over one pint. The 
amount is reduced until it is retained; only one- 
third of an ounce may be administered. The number 
of nutrient enemas required every day will depend 
upon the patient’s condition. 

Indications for nutrient enemas are extreme 
weakened conditions, caused by fevers of long dura¬ 
tion, and the food cannot be retained by the stom¬ 
ach; when it is impossible to swallow, caused by 
tumors or paralysis; conditions like disease of 
the stomach, when it is important to give the stom¬ 
ach a rest; in severe forms of nervous dyspepsia or 


Page Two Hundred Ninety-five 



LECTURES OF INTEREST TO WOMEN 


irritable stomach; also in cases of vomiting, due 
to pregnancy, nutrient enemas may be given to sup¬ 
ply nourishment to the body while the stomach can¬ 
not retain food. Oftentimes insane or delirious 
patients must be fed temporarily per rectum. 

In children, nutrient enemas are used only 
temporarily (for two or three days), until the con¬ 
dition for which it was given shows signs of im¬ 
provement . 

Paragraph 760 

NOURISHMENT TO USE. Many nutrient formulas 
are given in various text books, but we think the 
best results are obtained by using peptonized 
skimmed milk. To peptonize milk for rectal feed¬ 
ing, add one-fourth of the contents of a Fairchild’s 
peptonizing tube to four ounces of skimmed milk, or 
in like proportion. Place the pitcher, containing 
the solution, in water at a temperature from 110 to 
120 degrees F., and let it remain for twenty min¬ 
utes. It is claimed that skimmed milk is more com¬ 
pletely assimilated than any other kind of food 
used for rectal feeding. It will give the patient 
the proper nourishment and strength better than 
any other kind of nutriment. 

If it is desired that more liquid be absorbed 
by the intestines, the milk may be diluted by using 
a normal salt solution. Take two parts of skimmed 
milk and one part salt solution; this makes a very 
good preparation. Or when a large amount of liquid 
is required, equal parts of milk and normal salt 
solution may be used. 

The white of an egg is also a good food, and 
it is the second choice when milk cannot be ob¬ 
tained. Take the whites of three raw eggs, and mix 
it with the required amount of normal salt solution. 
The white of egg can also be added to the skimmed 
milk; one or two as the case may require. 

The nutrient enema is given every six to 
eight hours, and the amount used each time will 
vary with age and condition of the child. Two to 
four ounces can be given to a child up to three 
months of age; and from that time until the sixth 


Page Two Hundred Ninety-six 




TRAINING OF INFANTS AND CHILDREN 


month, four to six ounces; from six months to two 
years, six to eight ounces, ana after two years, 
eight to sixteen ounces. 

Paragraph 761 

COMMON ERRORS IN FEEDING. The most frequent 
error in the feeding of infants and children, is 
over-feeding (giving more than is necessary), or a 
stronger mixture than a child is able to digest. 
Especially is this true at the commencement of bot¬ 
tle feeding; quantity is too large, and intervals 
between feedings are too short. It must also be re¬ 
membered that children of the same age cannot all 
be fed alike. It depends upon the size and weight 
and general health of the child as to the amount of 
food required. Healthy children of equal weight 
will probably require the same amount of food, but 
the larger the child, the greater the amount of food 
required. 

Paragraph 762 

An infant that weighs fifteen ounces at six 
months, would require about 6 ounces of food, and 
this quantity should be diminished a half an ounce 
for every pound under this weight, until the total 
quantity is reduced to 4 ounces, and for every pound 
over fifteen, add a half an ounce to each additional 
feeding until the total is increased to 9- ounces. 
The number of feedings in the twenty-four hours 
should be the same for all children at a given age. 

Paragraph 763 

Many children are kept on an exclusive milk 
diet until they are twelve months of age or older, 
which is wrong. Starches in some form should be 
added to the food at the seventh month, and under no 
circumstances, not later than the ninth month. A 
great mistake made by mothers is to allow a child, 
from the twelfth month to the third year, to have 
a diet composed largely of milk and not a sufficient 
amount of common cereals. How often we see chil¬ 
dren fed on crackers and milk, bread and milk, com¬ 
mon and fancy crackers, during the very important 
period of their growth. Mothers should know that a 
high proteid food is necessary for the proper de¬ 
velopment of their children. 


Page Two Hundred Ninety-seven 




LECTURES OF INTEREST TO WOMEN 


During infancy, milk answers well, but dif¬ 
ferent kinds of food are required for older children. 
Eggs, cereals, broths, oatmeal, farina, etc., are 
absolutely necessary to normal growth. Another ■ 
great error that a mother makes in feeding her child 
is the irregularity as to the time the food is given. 
The child should have its meals on the minute, at the 
same time each day. 'Disobeying this most import¬ 
ant rule will promote a loss of appetite and indi¬ 
gestion. 

Eating between meals, whether bread and but¬ 
ter, pastry, or confectionery of any kind, if prac¬ 
ticed continually, is sure to be followed by indi¬ 
gestion and malnutrition. Never coax or force food 
upon a child. When the proper food is given at the 
correct time, the'normal child will be hungry and 
will eat the required amount. If it is not hungry, 
then there is some cause for the loss of appetite, 
which must be discovered and receive the proper 
treatment. 

Parugraph 764 

FORCED FEEDING. 

Forced feeding or gavage (the technical 
name) is to introduce nourishment into the child’s 
stomach by means of a tube. There are special tubes 
known as ‘‘stomach tubes’’ for children, or you 
may take a rubber catheter American No. 12, a piece 
of glass tubing about two inches in length and one- 
eighth inch in diameter; two feet of one-quarter 
inch plain rubber tubing, and a small glass funnel. 
Connect the catheter and tubing with the glass 
tubing and attach the funnel to the other end of the 
rubber tubing. An opening should be made in the 
catheter about one-half an inch from the original 
one, which will allow a more rapid introduction of 
the nourishment. The opening should be made with a 
small pair of curved scissors. The rubber catheter 
is dipped into the solution to be used and passed 
into the stomach, with the funnel empty, and the 
nourishment is immediately poured into the funnel. 
When the food has passed into the stomach the tube 
should be compressed and quickly withdrawn. It is 
necessary to compress it in order to keep the food 


Page Two Hundred Ninety-eight 




TRAINING OF INFANTS AND CHILDREN 


from escaping into the throat which would cause 
choking and perhaps vomiting. 

The position of the child for gavage may be 
on its side, or it may rest on its back. It is well 
to wash the stomach out with warm water before each 
feeding. With infants without teeth, the index 
finger is all that is necessary to keep the mouth 
open. In children with teeth a simple mouth gag 
should be used. A sufficient quantity of water may 
be given with the nourishment selected, so that the 
child with hare-lip may get as much liquid as it 
is accustomed to in normal condition. The amount 
of food given should be a quantity suitable to the 
age of the child. 

Before each feeding it is well to introduce a 
few ounces of water and withdraw it to see if any 
food of the last feeding is still in the stomach and 
if it has been properly digested. By this means of 
feeding, the child will make a regular daily gain, 
and in cases of severe illness, where the child 
seems to be too weak to swallow, there will be the 
proper assimilation of food if it is placed in the 
stomach. Therefore, gavage is useful in other 
cases besides hare-lip, and we should never say that 
any case of sickness is hopeless as long as the child 
is breathing. After a few days’ feeding in this 
way the child will take food from the bottle or 
spoon. Breast milk can be given by gavage as suc¬ 
cessfully as modified cow’s milk. 

The food for forced feeding in hare-lip 
cases should be the same as that which is given in 
normal cases—breast or modified cow’s milk.. Forced 
feeding is given once every four to six hours, with 
from one-third to one-half the quantity of food 
given in health, and it may be" employed advantage¬ 
ously for several days at a time. It is much superior 
to rectal feeding in children, because this can 
only be continued for a day or two, as it soon be¬ 
comes intolerant, but gavage or forced feeding is 
the only way by which a child, who has hare-lip, or 
any severe illness like diphtheria, pneumonia, or 
grave intestinal diseases, can be properly nour¬ 
ished. In these cases, forced feeding may save the 


Page Two Hundred Ninety-nine 



LECTURES OF INTEREST TO WOMEN 


life of the child. In such cases, peptonized milk, 
dextrinized gruels, broths, or gruels and broths 
combined, constitute the foods to be given. 

Paragraph 765 

TEETHING (DENTITION). 

The period of teething as a rule is a very im¬ 
portant time in the care of the child, and causes 
more or less anxiety on the part of the mother. 

Paragraph 766 

SYMPTOMS OF TEETHING. When teething begins, 
the baby generally becomes fretful and peevish; 
puts its fingers in its mouth, and may have fever 
from one to two degrees; often very restless when 
asleep and frequently will cry out during its sleep. 
There is a continual drooling, and the saliva is 
sufficient to soil the dress or bib quite frequent¬ 
ly. The gums are red and swollen. 

Paragraph 767 

APPEARANCE OF THE TEETH. The first set of teeth 
that a baby has consists of twenty. The first teeth 
to come through are the two lower front teeth, and 
they gradually appear from the fifth to the ninth 
months. Then come the four upper front teeth, 
which appear from the eighth to the twelfth months; 
next, one comes on each side of the two front, and 
at the same time there are two above and below a 
little farther back, leaving space for what is 
known as the stomach and eye teeth. The stomach and 
eye teeth appear from the eighteenth to the twenty- 
fourth months, and last, the second molars appear 
about the twenty-third to the twenty-fifth months. 

Paragraph 768 

TREATMENT OF TEETHING. When the first symp¬ 
toms appear, it is a good idea to lessen the quan¬ 
tity of the diet. Cut down in the milk and cream, 
especially the milk. Give the baby the same quan¬ 
tity, but dilute it from one-fourth to one-half, as 
the severity of the case demands. If every precau¬ 
tion is taken in regard to baby’s food, that is, 
being clean with nipples, bottles, etc., there is 
less danger of having trouble. 


Page Three Hundred 



TRAINING OF INFANTS AND CHILDREN 


Here we might repeat that the milk should he 
perfectly fresh, and all utensils used in baby’s 
feeding should be clean. Give the baby sips of cold 
water for the hot dry mouth. Gently rub the gums 
with your bare fingers. Give the baby an ivory ring, 
or other hard thing, to bite on, especially when 
there is evidence that the tooth is almost through; 
or take a towel and place one thickness over your 
first finger, then rub the baby’s gum with this 
directly over the tooth. Use quite a little pres¬ 
sure. The gum may bleed a little, and the whole 
tooth will be seen. Do not rub all the tooth through. 
As soon as you have broken the surface of the gum, 
the tooth will gradually force its way through with¬ 
out any more help. Bottle-fed babies have more 
trouble and are slower in cutting their teeth than 
breast-fed babies. 

If any serious complications develop while 
teething, such as vomiting, green stools, diarrhea 
or convulsions, the child should receive the atten¬ 
tion of a physician, as diarrhea occurring in teeth¬ 
ing is as dangerous as at any other time. It must be 
remembered that teething rarely, if ever, causes 
any such serious conditions. 

Paragraph 769 

CARE OF THE TEETH: The daily care of the teeth 
is as important with children as it is with adults. 
A child should be taught early to use its tooth 
brush daily, and when any of the teeth in children 
begin to decay a dentist should be consulted, and 
they should have the proper care and attention. 
Teeth should not be allowed to decay in the mouth, 
and do not allow the decomposition of food which 
lodges in and about the spaces between the teeth. 

It is very important that the mouth and teeth should 
be kept perfectly clean, and every mother and nurse 
should strive to see that the children under their 
care have perfect teeth. 

Paragraph 770 

The teeth should be brushed up and down with 
a rolling motion of the brush. There are a great 
many preparations for cleaning and preserving the 
teeth, but a tooth brush faithfully used with salt 


Page Three Hundred One 


LECTURES OF INTEREST TO WOMEN 


and water will accomplish all that can be desired. 
Many persons prefer a tooth cleanser in the shape of 
powder; others in the form of a cream, and there are 
many on the market. Probably one is about as good 
as the other. An excellent powder to preserve the 
gums, and prevent pyorrhoea from developing, is 
Pyorrhocide, and we recommend its use, but it is not 
so essential that any one kind of a tooth powder or 
paste be used. The success of keeping the teeth in 
perfect condition is the faithful daily use of the 
tooth brush. 

Sometimes the narrow passages between the 
teeth cannot be reached with the tooth brush; in 
that case a dental floss will remove the particles 
of food lodged between the teeth. The dental floss 
is better than the use of a wooden tooth pick, be¬ 
cause oftentimes it does not penetrate between the 
teeth. We believe that dental floss drawn between 
the teeth will do more to prevent decay and preserve 
the fillings you already have than anything else. 

The teeth should be cleaned twice a day, 
especially in the evening. At that time a person 
can take sufficient time .to use dental floss and 
give the teeth the necessary care. 

The teeth should be examined once in six 
months by a dentist, but if the above suggestions 
are faithfully carried out there will be little 
filling to be done, and when it is necessary, the 
fillings will remain permanently by keeping the 
mouth and teeth perfectly clean and free from the 
decomposition that takes place by allowing food to 
remain in and about the teeth. 


Paragraph 771 

ERUPTION OF PERMANENT TEETH. The eruption 
of permanent teeth varies a great deal in different 
children. The teeth of the lower jaw are first, 
and the corresponding teeth above come later, even 
months after the corresponding ones below. Most 
everyone is familiar with the fact that the third 
molar teeth are delayed for some time; often 
not appearing until after the twenty-fifth year. 


Page Three Hundred Two 



TRAINING OF INFANTS AND CHILDREN 


The following table gives about the average time: 


Age. 


Permanent Teeth. 


6 

7 

8 
9 

10 

11 

13 

17 


years.Four first incisors. 

years.Four central incisors. 

years.Four lateral incisors. 

to 10 years.Four first bicuspids. 

to 11 years.Four second bicuspids. 

to 13 years.Four canines. 

to 15 years.Four second molars. 

to 25 years.Four third molars . 


Paragraph 772 

TOOTHACHE. When a child has toothache or de¬ 
cayed teeth, it is well to give a few doses of 
calomel; follow it with saline laxatives and apply 
heat to the face. 

The child should be instructed early in life 
to use the tooth brush, and to keep the teeth per¬ 
fectly clean. When any cavities are noticed, the 
dentist should be consulted so that they may receive 
the proper treatment. When there is a cavity, and 
you wish to treat the tooth, a little piece of cotton 
saturated with oil of cloves may be placed in the 
cavity. When the first set of teeth decay and cause 
trouble, they should be under the care of a dentist. 


Paragraph 773 

GUM-BOILS. 

When the root of a tooth becomes diseased, 
and we often find this in decayed teeth before the 
eruption of permanent teeth, inflammation causes 
abscesses to form in the gums. The face becomes 
badly swollen in such cases, and is very painful. 
At the beginning, if the gum is painted with tinc¬ 
ture of iodine, it may prevent the formation of an 
abscess, care being taken not to use the iodine 
too freely. 

Hot applications to the cheek, applying hot- 
water bottles, or any form of dry heat, will assist 
greatly in relieving the pain. When it is certain 
that the abscess is going to form, it should be 
lanced and not allow the pus to accumulate until 
the abscess ruptures of its own accord. 


Page Three Hundred Three 











LECTURES OF INTEREST TO WOMEN 


Paragraph 774 

FOREIGN BODIES IN THE EYE. 

Quite often a small piece of cinder, or other 
minute sharp particle of some kind, will get into 
the eye, and sometimes the tears will wash it out, 
but it generally adheres firmly upon the under 
surface of the upper lid. 

To look for the foreign body, first wash the 
hands, and then with the thumb and forefinger of the 
left hand, seize the eye lashes of the upper lid, 
and pull it away from the eye. Take a lead pencil 
or toothpick, and instruct the child to look down. 
At the same time, press the lead pencil or toothpick 
against the middle of the upper lid, and pull the 
lashes upward. This will invert the lid and the 
foreign body can generally be seen firmly adhered 
to the lid. With a cotton applicator, dipped in 
sterile water or boracic acid solution, gently 
remove the foreign body. 

After it is removed, the irritation may 
persist for some time, and this is relieved by wash¬ 
ing the eye out with boracic acid solution. If the 
eye is inflamed to any great extent, put a drop or 
two of a 20 per cent argyrol in the eye two or 
three times a day. Hot applications of boracic acid 
may be applied; this is done by using a piece of 
gauze wrung out of the solution and applied to the 
affected eye. It must be changed often, and should 
not be too heavy. 

If the foreign body cannot be removed, or if 
it cannot be found, and the irritation continues, 
an eye specialist should be consulted. 

NOTE. Sometimes with shop workers, or per¬ 
sons operating emery wheels, a piece of steel 
penetrates the eye-ball. In examining the eye, if 
nothing appears on the upper lid, look carefully 
and see if it can be seen embedded in the eye-ball 
itself. When an accident of this kind occurs, 
professional aid must be had at once, as there is 
great danger of injuring the covering of the eye¬ 
ball, forming an ulcer, which might result in 
serious after-effects. 


Page Three Hundred Four 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 775 

FOREIGN BODIES IN THE EAR AND NOSE. 

Children are in the habit of pushing buttons, 
beans, beads, peas, and similar objects into their 
ears and nose. If the object has been pushed very- 
far into the nose or ear, it should be left for a 
physician to remove, but if it is impossible to 
secure a physician, a mother or nurse may endeavor 
to do something herself. 

If it is in the ear, the child should be laid 
on the affected side, and the tip of the ear should 
be pulled outward and backward. This straightens 
the canal, and sometimes, if the object is not 
lodged too tight, it will drop out by itself. If it 
does not, syringing the ear with warm water may dis¬ 
lodge it; using an ordinary ear or fountain syringe. 

To irrigate the ear, the patient should be 
seated; place a pus basin under the ear to catch the 
solution, and draw the ear outward and backward, as 
directed. Place the nozzle of the syringe at the 
upper part of the opening of the canal. This allows 
the water to get behind the object and wash it out. 
A mother or nurse should remember that a foreign 
body in the ear will not do any harm until the 
physician can be secured, as long as it is not giving 
any pain. 

Sometimes insects crawl into the ear, causing 
much suffering. In that case, a little warm sweet 
oil, glycerin, or castor oil should be dropped in 
the ear, and the ear syringed with warm water, 
about a half or three-quarters of an hour after 
putting in the oil or glycerin. 

When foreign objects are put in the nose, 
children often forget them, or they will not speak 
of it. They often cause inflammation and discharge. 
When discovered, if it is not too far in, or too 
firmly held by the swelling of the tissue, or by its 
own size, it may sometimes be removed by having 
the child blow its nose vigorously, or by irritating 
or tickling the nose with a feather, or by giving 
it a little snuff to cause it to sneeze. If this 
does not succeed, it is better not to make any 
attempt to remove it, because the child will cry 


Page Three Hundred Five 



LECTURES OF INTEREST TO WOMEN 


and any efforts will only have a tendency to force 
the object farther up into the nose. A physician 
should remove the object, because unskilled efforts 
to get it out would result in more or less injury. 

Paragraph 776 

SWALLOWING FOREIGN BODIES. 

Children often swallow objects like coins, 
marbles, buttons, etc.; occasionally safety pins. 
The former need cause no anxiety, and the safety 
pin, if closed, will generally pass without causing 
any trouble. In these cases never give any 
cathartic, but give the child a liberal meal of 
oatmeal mush, mashed potato, or bread. Aside from 
that, leave it absolutely alone. The bowel move¬ 
ments should be examined carefully every day for the 
foreign body. 

If the child has swallowed an open safety pin, 
it may possibly pass without any interference if 
the round end is pointed in the right direction, 
but it should be watched daily with an X-ray, in 
order to note its correct position, and should the 
point of the pin penetrate the tissue, or the pin 
become lodged in any given point, a surgical 
operation would be necessary. 

Sometimes pointed and angular articles, like 
fish-bones, jackstones, or a pin, may lodge in the 
throat, which causes the. child to cough. If this 
occurs, stand the child on its head, suspended 
by the feet, and slap it on the back, in effort to 
dislodge the object. 

Sometimes a foreign body can be grasped with 
the forefinger and thumb, but great caution should 
be exercised in attempting this. If it seems to 
have lodged in the lower part of the throat or in the 
passage to the stomach, it can be carried into the 
stomach by having the child swallow large mouth¬ 
fuls of soft food. 

In case a child swallows an open safety pin, 
or an object that lodges in the throat, and it cannot 
be removed, a physician must be called at once. 


Page Three Hundred Six 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 777 

HOW TO USE A FEVER THERMOMETER. Every mother 
should be acquainted with the normal temperature of 
a baby, in order that she may be able to appreciate 
the changes occurring in disease. There is no way 
to determine this except by the use of the clinical 
thermometer. It is impossible for us to tell if a 
child has fever by simply placing the hand upon its 
skin. Even the fact that the baby’s hands and feet 
are cold is not sufficient proof that it is not 
having a high fever at the same time. 

Paragraph 778 

The clinical thermometer should be in every 
household, and the mother should be taught how to 
use it correctly, and she should employ it whenever 
the child seems to be at all ill. She should also 
realize the fact that the degrees of fever which the 
thermometer may show is for the physician’s infor¬ 
mation more than for her own. The instrument used is 
self-registering; that is, the column of mercury 
which indicates the temperature will remain at the 
highest point reached. It is made entirely of glass, 
and the Fahrenheit scale is engraved upon, or with¬ 
in, the tube, and divides it into degrees and tenths 
of a degree. The arrow on the tube merely points to 
what is considered normal—that is, 98.6 degrees. 
The normal mark is disregarded altogether in making 
the reading. 

Paragraph 779 

KIND OF INSTRUMENT TO USE. The best pattern 
to use is called the 44 One Minute Thermometer’’. It 
would be a mistake to depend on the full elevation 
being attained in just one minute; a somewhat longer 
time (two or three minutes) is usually required. 
Most of the instruments are made to magnify the 
column of mercury in order to make it easy to read. 


Paragraph 780 

TAKING THE TEMPERATURE. The temperature may 
be taken under the arm, in the mouth, groin, or 
rectum. The groin does not give sufficiently accu¬ 
rate results. Temperature taken in the arm pits 
(under the arms) gives very poor results, and the 


Page Three Hundred Seven 



LECTURES OF INTEREST TO WOMEN 


readings thus obtained are very misleading, on 
account of not being able to keep the surface of the 
skin close enough together to exclude the air. The 
thermometer may be placed in the mouth of children 
of five or six years of age, who can be trusted not to 
bite upon it. 

When taking the child’s temperature, it is 
safer to have it lie down. The end of the thermo¬ 
meter containing the mercury should be placed under 
the child’s tongue, close its lips and hold the 
thermometer in place. Sometimes it is very diffi¬ 
cult to close the lips and keep the thermometer under 
the tongue. If you instruct the child to 4 4 suck it 
like a stick of candy, ’ ’ that being an action with 
which every child seems familiar, it will help a 
great deal in keeping the thermometer in place. 


Paragraph 781 

BY RECTUM. In infants and sick children, it 
is best to insert the thermometer in the rectum. In 
fact, it is best to take the temperature of all chil¬ 
dren and infants per rectum. It must be remembered 
that rectal temperature is about one degree higher 
than when taken in the mouth. To take rectal tem¬ 
perature, the child is laid on its back, or side, on 
the lap or bed, and the thighs flexed. The thermo¬ 
meter, bulb end, £.s oiled or vaselined, and is gent¬ 
ly inserted about an inch into the rectum and left 
there for two or three minutes. The procedure is 
simple, painless, and free from danger, and the 
temperature reading will be accurate.. 


Paragraph 782 

TIME. Temperatures are generally taken at 
8, 12, 4 and 8 o’clock. Especially is this true 
where it is necessary to secure what is known as a 
24 hour temperature curve. In some cases it may be 
necessary to take the temperature every hour, espe¬ 
cially when giving medicine to reduce the fever. 
Each time the temperature is taken, record the 
reading; also make note of the time it was taken for 
future reference. 


Page Three Hundred Eight 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 783 

CARE OF THE INSTRUMENT. After taking the 
temperature, the instrument should be held by its 
upper portion between the thumb and forefinger, and 
be swung or shaken forcibly until the column of 
mercury is made to descend in the tube far enough to 
bring the upper extremity of the mercury a degree 
or so below the normal mark. The thermometer should 
always be washed thoroughly with soap and cold water 
(never use hot water) after each time it is used, 
disinfect it with alcohol and place in its case. It 
is then ready for use at any time. 

Paragraph 784 

THE TEMPERATURE CURVE. It is well to remember 
that the slightest kind of an irritation may cause 
an infant’s temperature to rise and fall very quick¬ 
ly, and even a high temperature with an infant does 
not necessarily mean that there is any great danger 
existing. It is also well to remember that tempera¬ 
tures vary during the 24 hours. It is lowest in the 
morning, reaches its highest point in the afternoon, 
begins to sink again in the evening, and is at its 
lowest at midnight or the early morning hours. 

There may be a difference of one, two or three 
degrees between readings at different times of the 
day. In infants who are perfectly well, there is 
often quite a variation of temperature during the 
day, and it is not necessary to feel any uneasiness 
unless the temperature falls to 97 or 96 degrees, or 
rises to 100 degrees or more. Anything over 100 de¬ 
grees is considered a fever. 

Paragraph 785 

HOW TO GIVE A COLD BATH. A cold bath is given 
to reduce temperatures like in typhoid fevers, or 
where, a child has a continued high fever. The bath 
tub should be large enough to hold the child at full 
length. Fill the tub half full of water at a tem¬ 
perature of 90 degrees, then add cold water or ice 
until the temperature is gradually reduced to 70 
degrees. 

The duration of the bath should be from three 
to five minutes. Watch the pulse carefully, and if 


Page Three Hundred Nine 



LECTURES OF INTEREST TO WOMEN 


the slightest sign of weakness is noticed, or if the 
skin becomes blue, remove the child immediately 
from the bath and place it in bed with hot water 
bottles at its feet. Administer such stimulants 
as hot coffee or whiskey. It is often advisable, 
with children who have a weak pulse, to give the 
stimulant before the bath. 

While the child is in the bath, continually 
rub the skin to stimulate the circulation. The bath 
should be repeated every three or four hours, or 
oftener if the temperature requires it. The tem¬ 
perature of the child should be taken before and 
after the bath, and when the bath does not modify 
or lower the temperature, the temperature of the 
bath should be lowered to such a degree that the de¬ 
sired result is obtained. 


Paragraph 786 

TEMPERATURES OF THE DIFFERENT BATHS: 


Cold Bath.....Temperature of 40 to 70 degrees F. 

Cool Bath . ‘‘ ‘‘ 70 to 80 

Tepid Bath. “ “ 80 to 90 

Graduated Bath ‘‘ “ 85 to 90 ‘ ‘ 

Warm Bath . “ “ 90 to 100 

Hot Bath. “ “ 100 to 110 


Paragraph 787 

WHEN AN INFANT SHOULD NOT BE GIVEN A BATH. 

1. A full tub bath should not be given until the 
umbilical cord has separated, and the naval com¬ 
pletely healed. 

2. An infant should not be bathed sooner than 
one hour after taking food. A full hour should also 
elapse between the bath and before giving the child 
its airing. 

3. When the baby has a severe cough or cold it 
should not be given a bath without first consulting 
the family physician. 

4. A bath should not be given if it causes the 
color of the skin to become 'bluish, or if the baby’s 
hands and feet become cold. 

5. If the skin seems to be tender, and chaps 
easily, you should not use soapy water. If the baby 


Page Three Hundred Ten 










TRAINING OF INFANTS AND CHILDREN 


has eczema on the face, edge of the hair, or in fact 
if any part of the skin is affected, those parts should 
not be bathed until a physician is consulted. Any 
tender skin should not be washed frequently with 
strong soapy water, as it causes severe chafing. In 
such cases all bathing should be temporarily discon¬ 
tinued. 

Paragraph 788 

MUSTARD BATH. A mustard bath is of great 
value in infancy and childhood, in cases where a 
powerful stimulant is needed, or when a child is 
rapidly failing from any cause, and it is much bet¬ 
ter than a simple warm bath when it is desired to 
hasten or bring out the rash in any of the eruptive 
fevers. 

To make a mustard bath, take 2 to 4 table¬ 
spoonfuls of ordinary mustard (not Coleman’s) to 
a gallon of water. If Coleman’s mustard is used, 
it only requires about half the amount just men¬ 
tioned. A mustard bath is generally given at a tem¬ 
perature of from 90 to 100 degrees, or what is known 
as the 4 ‘Warm bath. ’ ’ 

Paragraph 789 

HOT COMPRESS, or fomentation, is made of a 
piece of flannel folded three or four times into 
the form of a pad. This is placed in an open towel, 
dipped into boiling water, wrung out thoroughly 
by twisting the towel, removed from it, tested by 
the nurse against her cheek to ascertain that it is 
not too hot, applied to the part, and covered quick¬ 
ly with oiled silk and a folded dry towel, with or 
without a bandage. The fomentation should be re¬ 
newed every half hour if we wish to keep up decided 
heat; or a hot water bottle, containing only a small 
amount of hot water, can be placed on the dry towel. 
Then the compress would not need to be changed so 
often. It is often very useful in relieving pain 
and controlling inflammation. 

Paragraph 790 

COLD COMPRESS. To apply a cold compress, which 
is often prescribed by a physician, and is good in many 
cases of acute inflammation of various kinds, take 
a thin cloth, such as a handkerchief, or a piece of 


Page Three Hundred Eleven 



LECTURES OF INTEREST TO WOMEN 


well worn sheet, fold it in three or four layers, wring 

it out of cold water (ice-water if it can be obtain¬ 
ed) , and lay it on the affected parts. 

The addition of one-third alcohol to the water 
has a tendency to increase its efficiency. It must 
be changed often (every 10 or 15 minutes) as it be¬ 
comes warm very quickly, and is then of no value. 

Where it can be arranged, and where the physi¬ 
cian has ordered a continuous cold compress, take an 
ordinary fountain syringe, and fill it full of ice- 
water, or cold water, tie a cord around the tube, and 
arrange it so that it will just drip, drop by drop, 
continuously on the cloth, then the cloth need not be 
changed. 

Arrange a Kelly pad, or a rubber cloth, or or¬ 
dinary oil-cloth, under the affected part, so that the 
water will drain into a vessel; this will prevent the 
child from getting wet. A rubber cloth or Kelly pad 
should be used regardless of whether you wring the 
cloths out of cold water and apply them often, or 
whether you use the drop method of keeping the cloth 
wet and cold. The ice-bag is often used in like man¬ 
ner, and for the same purpose. 

Paragraph 791 

HOW TO GIVE AN ICE PACK. The best way to give 
a child an ice pack is to place a rubber sheet on the 
bed, then a pad on that; a very large towel or a crib 
sheet should next be placed in lukewarm water 
wrung out and wrapped about the naked child, fold¬ 
ing a part of it around each arm and leg; a piece of 
ice about as large as one’s fist should then be 
•gently ironed over the entire body, covering the 
places under the arms, and in the groins especially. 
An ice-cap should be at the - head while this is be¬ 
ing done, and if the feet are at all cold, a hot 
water bag should be placed there. 

This may be kept up for ten or fifteen minutes 
if the child does not become blue; if he does, he 
should at once be removed from the pack, and heat 
applied while he is rubbed with a warm hand, and a 
little stimulant given. This blue appearance rare¬ 
ly takes place, however. After the ice rubbing 
the child may be left in the wet sheet for an hour 


Page Three Hundred Twelve 





TRAINING OF INFANTS AND CHILDREN 


or so, then the temperature taken, and if it has 
dropped a little, or if the child seems more com¬ 
fortable, the wet sheet may be removed and the 
nightdress slipped on with a light covering over 
it. 

Paragraph 792 

MUSTARD PLASTER, strictly speaking, is a 
poultice, as when used for children the mustard is 
added to flour or flaxseed meal, and the whole mois¬ 
tened and heated. One part of mustard should be 
mixed with three or four, or in the case of infants 
five, parts of flour or flaxseed meal. Boiling wa¬ 
ter is added, and the mixture stirred until it is of 
the proper softness. It is then spread on a cloth 
and applied directly (cloth side) to the skin. If 
it should, burn too much, a layer of linen or some 
other thin material can be placed between. It should 
be kept on until the skin is well reddened, but not 
long enough to blister. After removing it, the 
skin should be wiped clean. 

A plaster less likely to burn is prepared by 
mixing one tablespoonful of mustard, three or four 
of flour, the white of one egg, and a teaspoonful 
of glycerine. The prepared mustard plasters sold 
by druggists are usually too hot for use with child¬ 
ren. They may be employed in emergencies, however, 
mitigating their strength by covering them with 
one or two layers of a wet pocket handkerchief or 
table napkin. 

Paragraph 793 

POULTICES. 

A poultice is used when it is desired to re¬ 
tain heat, on any affected part, for the greatest 
length of time without frequent changing. It should 
not be too heavy or it will cause discomfort. Half 
inch or less is the right thickness, of course the 
thicker it is the longer it will stay warm. 

Before applying a poultice the mother or nurse 
should test it against the cheek, always apply it 
slowly, lest it feels too hot to the child. 

There are many kinds of poultices, the fol¬ 
lowing are the most commonly used: 

Paragraph 794 

FLAXSEED POULTICE. One of the best-known 


Page Three Hundred Thirteen 


LECTURES OF INTEREST TO WOMEN 


and most serviceable kind. Heat a sufficient 
quantity of water in a tin or china dish almost to 
boiling point. Add flaxseed meal slowly, stir¬ 
ring constantly and vigorously with a spoon until it 
is of the consistency of hot mush, too thick to flow. 
Spread this with a case-knife upon a piece of cot¬ 
ton or linen cloth; fold the edges over slightly, 
and cover it with an old pocket-handkerchief or 
piece of thin linen, cheese-cloth, or netting. 

Test to see that it is not too hot; apply, cover with 
oiled silk or paraffin paper, and bandage on. Re¬ 
new every few hours. The addition of a little oil 
will keep it soft longer. Everything must be in 
readiness before the poultice is mixed, or it will 
grow cold, and the old poultice should not be re¬ 
moved until the new one is prepared. 

SLIPPERY-ELM POULTICE. Prepared from ground 
slippery-elm bark in the same way as the flaxseed 
poultice. 

Paragraph 795 

BREAD - AND - MILK POULTICE. A popular and 
easily prepared poultice. Stale bread-crumbs are 
stirred into hot milk until the proper consistency 
is attained. It should be kept hot a few minutes to 
ensure the bread being well softened, then spread 
and applied. Water may be used instead of milk. 

Paragraph 796 

BRAN POULTICE. When a flaxseed poultice 
would be too heavy, as in some cases of pain and 
tenderness in the abdomen, a bran poultice may be 
used. A flannel bag is partly filled with bran, 
thoroughly wet with boiling water, wrung out in a 
towel, and applied. 

Paragraph 797 

HOP POULTICE. Prepared and used exactly as 
the bran poultice, over which it has no particu¬ 
lar advantage except that it is still lighter. 

Paragraph 798 

STARCH POULTICE. Thick boiled starch is 
spread warm on a cloth and applied directly to the 
skin without any covering between. It is used to 
lessen irritation in some affections of the skin. 


Page Three Hundred Fourteen 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 799 

PLASTERS. 

Plasters are used where counter irritants are 
needed, they should be applied as hot as the child 
can bear, watched carefully, so as not to blister 
the skin, and removed when the desired results are 
obtained. 

Paragraph 800 

SPICE-PLASTER. This is a very serviceable ap¬ 
plication for infants with colic; It is composed of 
a mixture of spices which druggists combine in dif¬ 
ferent ways'. One formula consists of 1 part each of 
ground ginger, cloves, cinnamon and allspice, with 
or without 1/8 part of Cayenne-pepper, according 
to whether the plaster is to be strong or weak. Put 
the dry and well-mixed powder into a flannel bag, 
spread it evenly, and quilt the bag to prevent the 
spices from forming into lumps. Before applying, 
wet it with hot diluted alcohol or hot whiskey. 

The same spice-bag may be used repeatedly until it 
begins to lose its strength. 

Paragraph 801 

PEPPER-PLASTER. These old-fashioned but ex¬ 
cellent preparations are of service in mild bron¬ 
chitis or sore throat. Lard or still better, 
mutton-suet is spread evenly on a cloth and black 
or red pepper is dusted rather thickly over it, use 
less red than black pepper. 

Paragraph 802 

NUTMEG-PLASTER. Prepared and used in the same 
way as the pepper plaster. 

Paragraph 803 

CAYENNE«- PEPPER - PLASTER. Is made by taking one 
teaspoonful of Cayenne pepper to 15 or 20 tablespoon¬ 
fuls of flour; make a thin paste and apply on a thin 
cloth, sift the pepper and flour several times in 
order to thoroughly mix them before adding the water. 


Paragraph 804 

COTTON JACKET. The cotton jacket is ordered by 
physicians in cases of pneumonia and other lung 
troubles in children. A waist of gauze, cheesecloth. 


Page Three Hundred Fifteen 



LECTURES OF INTEREST TO WOMEN 


or other light weight of muslin, should be fitted to 
the chest, reaching high in front and back, and 
tying or pinning it over the shoulders in front, 
or down one side under the arm. To the inside of the 
waist, a thick layer of absorbent cotton is loosely 
attached by sewing it through and through in several 
places—quilting it on. 

A cotton jacket retains the perspiration, keep¬ 
ing the skin moist and warm, and in that way assists in 
controlling inflammatory conditions of the lungs. 

When a cotton jacket is used, hot camphorated 
oil, well rubbed in, is freely applied to'the chest 
(both front and back) two or three times a day. Cam¬ 
phorated oil is a splendid remedy for acute lung 
troubles , and should be applied in connection with the 
cotton jacket. It will generally be ordered by the 
attending physician. 

When it is necessary to remove the jacket, grad¬ 
ually remove it by cutting one or two inches off the 
bottom of the waist each evening. In that way it can 
be removed a small portion at a time without any dan¬ 
ger of the child taking cold. 

Paragraph 805 

COLON IRRIGATION IN INFANTS AND CHILDREN. 

WHEN GIVEN. This is given when a child has a 
temperature of 102 degrees and over, with frequent 
bowel movements associated with mucous-like pas¬ 
sages; when the temperature is high, that is, 105 or 
106 degrees; when there is intestinal infection 
(gastro-intestinal disorders) with a high fever and 
infrequent bowel movements; when there is a sub¬ 
normal temperature and intense prostration. When a 
child has colic a good colon irrigation will often 
give relief, and occasionally when there is no 
movement without assistance, a.colon'irrigation 
may be given every six to eight hours, or once in 
twenty-four hours, as may be ordered by the physi¬ 
cian. When it is only necessary to move the bowels 
an enema is all that is required. 

Paragraph 806 

SOLUTION USED. A normal salt solution is the 

A 

kind of solution that is generally used, using a tea¬ 
spoonful of salt to a pint of water, and sometimes 


Page Three Hundred Sixteen 


TRAINING OF INFANTS AND CHILDREN 


it is necessary to give it only half strength—the 
irrigation to he continued until the solution re¬ 
turns clear. One quart will generally he sufficient. 
The temperature of the solution should be 95 deg. F. 
When it is given during a subnormal temperature and 
intense prostration, the temperature should be 
about 110 degrees. Your physician will order the 
kind of a solution to use—the amount, temperature 
and frequency the irrigation should be given in any 
case of serious illness. 

Paragraph 807 

COLD SOLUTION. In cases where the fever is 
high, a cold solution will reduce the temperature 
to a marked degree. In this case the temperature 
of the solution should be as low as 70 degrees. In 
using a colon irrigation to reduce the temperature, 
use as much as four to six pints. Such an irrigation 
will often reduce the temperature two or three 
degrees. 

Paragraph 808 

HOW TO GIVE. To give a colon irrigation, 
take an ordinary fountain syringe with a small rec¬ 
tal tip, or if the tip is too large use a straight 
medicine dropper, and attach it to a soft rubber 
catheter. If you use the medicine dropper, put the 
large end into the tube of the fountain syringe and 
the small end into the catheter. Be careful, in 
selecting a soft rubber catheter, that the walls 
are sufficiently thick, so that the tube will not 
easily bend upon itself. 

Paragraph 809 

IF POSSIBLE, the catheter should be intro¬ 
duced into the rectum -until it passes into the de¬ 
scending colon. In treating the average child it 
should be inserted into the bowel six to nine inches, 
and oftentimes gentle palpation over the left side 
of the abdomen will enable one to readily locate it. 
In infants it is not inserted as far as in older 
children. 

Paragraph 810 

THE INFANT should be placed on its back, with 
the buttocks slightly elevated by holding it by the 
feet. This will hold the buttocks close together, 


Page Three Hundred Seventeen 




LECTURES OF INTEREST TO WOMEN 


and the slight elevation will assist in allowing 
the solution to enter the large intestine, making 
the irrigation more effective. The bag should be 
held three feet above the child’s body. The cathe¬ 
ter, before it is inserted into the rectum, should 
be well lubricated with sweet oil, vaseline or 
glycerine, and the irrigation should be continued 
until the solution returns clear. 

In cases where there i's more or less depres¬ 
sion, it will be beneficial if the child can absorb 
more or less of the solution; therefore, after it 
returns clear, it is a good idea tq have the child 
retain as much of the clear solution as possible by 
placing the child on its left side with the buttocks 
elevated, and after a few ounces (three to five) has 
passed into the bowel, the tube should be quickly 
removed, and the child kept quiet for some time, 
with buttocks elevated. 

Paragraph 811 

When it is necessary for the child to absorb 
the normal salt solution, it is often given by the 
Murphy drop method. When it is necessary just to 
move the bowels by giving an enema of normal salt 
solution, it can be done by simply using a glass 
funnel attached to a soft rubber catheter, and the 
catheter is inserted only a short distance into the 
rectum, and sufficient solution poured into the 
funnel in order to obtain the desired results. When 
giving an enema in this way, the child may be lying 
either on its back or side. If there is any prefer¬ 
ence., it should be lying on its left side. 

Paragraph 812 

MURPHY DROP METHOD. In some cases of sickness 
the physician may recommend giving the saline solu¬ 
tion or a sugar solution by the drop method. This is 
done when it is necessary for the child to absorb a 
large amount of the solution. To give the solution 
by the drop method, take a fountain syringe and at¬ 
tach a small rubber catheter, the same as if you 
were going to give a colon irrigation. Have the 
solution at body heat and keep it that temperature 
by placing a hot water bag, with a given temperature, 


Page Three Hundred Eighteen 



TRAINING OF INFANTS AND CHILDREN 


on the outside of the bag that contains the solution, 
then tie a string around the tube so that the solu¬ 
tion will just drop out of the end of the catheter 
—say about 40 drops per minute—then insert the 
catheter into the rectum three or four inches and 
leave it there. The solution passing through the 
tube so slowly will cool very quickly, so it will be 
necessary to keep it quite warm in order that when it 
drops out of the catheter it will be the proper tem¬ 
perature. Test the temperature of the solution 
before the catheter is placed into the rectum by 
letting it drop upon the hand. 

Paragraph 813 
ENEMA. 

An enema is an injection of a certain kind of 
a solution into the rectum or bowels (the descend¬ 
ing colon) for the purpose of securing a bowel 
movement, or to remove gas from the intestinal 
tract. 

There are two kinds of enemas: low and high. 
For the low enema, the small rectal tip is used, and 
the solution only enters the lower bowel. For a 
high enema, the rectal tube, or soft rubber 
catheter, is passed up into the bowel eight to ten 
inches in older children, and from four to six 
inches in infants. Vaseline the tube or tip well 
before using. 

The articles required to give an enema are a 
fountain syringe or douche can, small rectal tip, 
soft rubber catheter or child’s rectal tube. When 
it is desired to give a high enema, the rectal tube, 
or catheter, is slipped over the rectal tip. When 
giving a low enema to infants, the common ‘‘Infant 
Syringe’’ is often used. 

If possible, when giving an enema, have the 
child lying on its left side. Place the fountain 
syringe about four feet above the child. For 
ordinary use have the solution quite warm, but not 
hot. When a high enema is given to reduce fever, it 
should not be warm. 

The solutions used for children are the soap¬ 
suds enema and the saline (normal salt solution); 


Page Three Hundred Nineteen 


LECTURES OF INTEREST TO WOMEN 


the soapsuds for giving a low enema, and the saline 
for the high. Different kinds of solution are 
used and will be prescribed by the physician as 
needed for any given case. The mother or nurse 
should use only the soapsuds or saline, unless given 
special orders. The amount of solution used should 
correspond with the age of the child; using only 
what the child can retain with comfort. 

An enema is given in various diseases and 
conditions; such as colic, convulsions,.or any 
case where we have acute indigestion with persistent 
vomiting. A high enema should always be given at 
the beginning of any illness where there is vomiting 
and constipation. Low enemas are given for consti¬ 
pation, when it is desired to form a habit for the 
bowels to move at a regular time each day. It should 
be a standing order for the mother or nurse to give 
an enema in any case of sickness if the bowels do 
not move once in the twenty-four hours. 

Paragraph 814 

BED WETTING OR INCONTINENCE OF URINE 

When a child has had the proper training, and 
has reached the third year and cannot control the 
urine, it has what is known as ‘‘Incontinence of 
Urine’ ’ . A child at this age should go from eight to 
nine hours without urinating at night, and from two 
to three hours during the day. When a child cannot 
do this, the case needs medical attention, unless 
it is simply a bad habit the child has acquired, 
whose training has been neglected, which is often 
the case. When it is not due to improper attention 
and training, it has many causes, some of which are 
very difficult to overcome. 

Paragraph 815 

CHILDREN WHO ARE ANEMIC, boys who have not 
been circumcised, and girls who have inflammation 
of the vagina, worms, strongly acid urine, nervous¬ 
ness, adenoids and enlarged tonsils, all have a 
tendency to cause incontinence of urine, and should 
be considered when a child has this difficulty. 

When a child has incontinence of urine, the 
bladder is completely empty, and it occurs more 


Page Three Hundred Twenty 


TRAINING OF INFANTS AND CHILDREN 


frequently at night than during the day. The bed 
may not be wet only once, but several times. Often 
this condition lasts for months, or even years, and 
many times it is very difficult to cure. Rewards 
and kindness, with the proper care and right treat¬ 
ment, are more effectual than punishment in con¬ 
trolling this habit. 


Paragraph 816 

TREATMENT: The treatment, of course, will 
depend upon the cause. The child should be examined 
by a physician, and if any of the above causes are 
found present, they should be corrected before you 
can expect to have any success in curing the habit. 
It is better that the case be under the supervision 
of your family physician. If incontinence occurs 
only at night, and the•child controls itself during 
the day, give a dry supper; no liquids after five 
o’clock in the afternoon. At that time give a glass 
of milk; absolutely no fluid after that time until 
the next morning - . Have the child empty its bladder 
just before it goes to bed; take it up at 10 or 11 
o’clock and have it empty the bladder again. In 
this way, it is often able to hold the urine until 
5 or 6 o’clock in the morning. 

Paragraph 817 

Give a supper of some cereal with a little 
butter on it, toast or bread and butter, a little 
well stewed fruit with a cracker—no liquids. 

Now if this treatment fails, let your physi¬ 
cian prescribe a treatment for the individual case. 

Paragraph 818 

There is a granule made by the Abbott 
Alkal'oidal Co., known as ‘ ‘ Incontinence Tablet’’. 
One granule is given every three or four hours, the 
last dose being given at bedtime. This granule is a 
good combination of drugs, and is a very good treat¬ 
ment after the causes have been removed. If the 
child should become flushed, a very bright red, 
while taking this granule, it should be stopped, or 
at least the dose diminished. The remedy- is gen¬ 
erally given until results are obtained. It is a 
good idea to stop the medicine after giving it a few 


Page Three Hundred Twenty-one 



LECTURES OF INTEREST TO WOMEN 


days, and then begin again. No mother should at¬ 
tempt to prescribe drugs for her child, unless she 
is thoroughly familiar with the disease. 

‘‘Unlimited Patience’’ is the watch-word in 
treating this condition. It may be necessary to 
treat the case for a year or more before a child is 
entirely cured, and mothers must heartily co-oper¬ 
ate with their physician, or else nothing can be 
accomplished. 

Paragraph 819 

AMOUNT OF URINE. The amount of urine a child 
should pass is as follows: 

Birth to 2 years. 8 to 12 ounces 

2 to 5 years.15 to 25 ounces 

5 to 10 years.y.,25 to 35 ounces 

10 to 15 years.35 to 40 ounces 

Adult life .52 ounces 


Paragraph 820 

TURPENTINE STUPE is made as follows: A piece 
of flannel is wrung out of hot water, as in prepar¬ 
ing a hot compress, and then sprinkled evenly with 
turpentine, about a half a teaspoonful being used 
for each square foot of flannel. It is then ap¬ 
plied, covered with oiled silk and a dry towel, and 
left on for a half to one hour, more or less de¬ 
pending on the degree of irritation it produces. 

Paragraph 821 

HOLDING THE BREATH. 

Holding the breath is a nervous disease, and 
occurs after great excitement, or in the act of 
swallowing. It occurs in infants as the result of 
fright or anger, and a child may often stop breathing 
until it becomes blue in the face and nearly uncon¬ 
scious. This affection is caused by a sudden spas¬ 
modic closing of the larynx. Sometimes no reason 
can be ascertained as to the cause of the child hold¬ 
ing its breath. Generally speaking, it is not con¬ 
sidered a serious condition, yet cases are recorded 
where they pass into convulsions and terminate in 
death from suffocation. When the attacks are 
frequent, and no fright or excitement can be noted 


Page Three Hundred Twenty-two 








TRAINING OF INFANTS AND CHILDREN 


as to the cause, we suppose the child has rickets or 
some other constitutional disease. 

TREATMENT. The treatment for children in the 
habit of holding their breath, to relieve the imme¬ 
diate attack, is to dash cold water from a glass 
into the face, or suddenly slap the face with a cold 
wet towel. This will produce a shock that will start 
the child breathing. Medicines which will act as a 
sedative on the nervous system may assist in con¬ 
trolling such a condition. 


Paragraph 822 

MOUTH BREATHING. 

Mouth breathing is an indication that there 
is some obstruction in the throat or nose, due to 
enlarged tonsils, adenoids, or some other nasal ob¬ 
struction. Children that breathe through the mouth 
continually for a long time, will develop a char¬ 
acteristic face expression, which will cause 
abnormal features and at the same time retard the 
mental development. 

Snoring is very rarely a habit in infants and 
children. The infant who breathes with its mouth 
open should have it closed, and kept closed by 
applying a bandage under the chin and fasten it on 
the top of the head. When a child breathes through its 
mouth, or snores during its sleep, it is a condition 
that should not be neglected, because there is some 
obstruction which compels the child to breathe in 
this abnormal manner. 

In mouth breathing, every mother should 
realize the importance of not neglecting the case, but 
have it attended to at once, as no child should be 
allowed to develop the habit of mouth breathing. A 
child is never too young but what it can have 
temporary relief, and be operated on later for per¬ 
manent relief. In young children, adenoids may 
return after they have been removed. In older 
children there is less danger of them recurring, but 
if they do, they should be removed, because if left 
until later in life, they may do a great deal of 
permanent harm. 


Page Three Hundred Twenty-three 


LECTURES OF INTEREST TO WOMEN 


Paragraph 823 

HICCOUGH. 

Hiccoughs are caused by some intestinal 
trouble; either the accumulation of gas in the 
stomach and bowels, or overloading the stomach with 
food, which causes a spasmodic contraction of the 
diaphragm. It is usually of little consequence, but 
if an attack is prolonged, an enema of soap water 
and a laxative of milk of magnesia should be given; 
or a Carminzym tablet (this for a child five years 
old) will generally give relief. 

When hiccoughs occur in any case of serious 
illness, it is looked upon as a grave symptom. 
Hysterical children that have been subject to un¬ 
usual excitement will have hiccoughs to an alarming 
degree. In such cases, a dose of the triple bromides, 
according to age, which may be repeated from fifteen 
to twenty minutes, will usually control the 
spasms. 

In infants, a quick change of position, or a 
little drink of hot water, in which has been placed 
a little soda mint, will often give relief. In 
older children, often drinking a glass of water, 
causing the child to laugh, or hold its breath for a 
few seconds, has proven effective in relieving hic¬ 
coughs. Any or all of the above treatments can be 
given, as the severity of the case demands. 

Paragraph 824 

SQUARE DIAPER. 

Square diapers are used by some, and are very 
satisfactory when properly applied. They fit 
loosely and do not irritate the genitals as much as 
the pointed diaper. 

It is applied by taking an ordinary diaper 
and folding it once. The folded edge is placed up¬ 
wards, and pinned around the infant’s thighs; then 
one side of the loose edge under the leg is pinned 
to the edge on the outside. Both sides are pinned 
the same; one or more pins are used as needed. 

In applying the square diaper, as well as 
any other kind, care should be taken that it is not 


Page Three Hundred Twenty-four 


TRAINING OF INFANTS AND CHILDREN 


too bulky between the thighs, as it has a tendency 
to keep the thighs apart and cause bow-legs. 

Great care should be used at all times not to have 
any kind of a diaper put on too tight. 

Paragraph 825 
SUCKING THE THUMB. 

A great many children develop the habit of suck¬ 
ing the thumb. It may not do any great amount of 
harm, yet there is nothing gained by the practice, 
and it should not be allowed. When a child sucks its 
thumb only when it is sick, or to quiet the nervous 
system when it wants to go to sleep, the trouble will 
generally correct itself, or it is very easily 
cured. In cases where the habit persists continu¬ 
ally, and the child sucks its thumb whether awake or 
asleep, it demands active treatment. Such a habit 
may result in deformity of the upper jaw, causing 
it to become angular in shape. The lower jaw becomes 
depressed, and this condition causes the upper teeth 
to grow forward. 

Paragraph 826 

TREATMENT. When a mother or nurse notices 
that the habit is being formed, gently remove the 
thumb, and direct the child’s attention along other 
lines. If the habit becomes established, bitter or 
disagreeable substance placed on the thumb will 
sometimes effect a cure (such as the infusion of 
quassia), but in bad cases all local treatment will 
be of no avail. The thumb must be forcibly kept out 
of the mouth. This may be done by placing the child’s 
hands in the metallic ‘‘Hand-I-Hold’’ mits. They 
are metal mittens that slip over the hand, and the 
cuff is pinned to the neck of the dress or to the 
child’s sleeve during the day. The child’s hands 
must either be placed in metallic mittens, or they 
must be pinned in the sleeves so that it is impos¬ 
sible to get the thumb in the mouth. 

The ‘‘Elbow Cuff’’ is also another very ef¬ 
fective way to cure thumb sucking. It is made by 
taking a piece of pasteboard, making a cuff and 
slipping it on the arm, and pinning it so that the 
center of the cuff is about even with the elbow. It 
should extend about halfway up to the shoulder, and 


Page Three Hundred Twenty-five 


LECTURES OF INTEREST TO WOMEN 


down almost to the wrist. This prevents the elbow 
from bending, and the child cannot get the thumb in 
its mouth, yet at the same time has free use of the 
hand and arm. Persistence in continual treatment, 
extending over a period of months, may be necessary 
in some cases to effect a cure. 


Paragraph 827 

BITING THE FINGER NAILS. 

This habit is very common in children and 
often continues in adult life, ruining the shape of 
the fingers. The cause is due to some nervous con¬ 
dition. 

Paragraph 828 

TREATMENT. The treatment consists of reliev¬ 
ing any nervous excitement, and improving the hy¬ 
gienic surroundings. If this cannot be relieved, 
the best way is to keep the finger nails forcibly 
out of the mouth by using the ‘‘Hand-I-Hold’’ metal¬ 
lic mittens, or applying infusion of quassia on the 
fingers (the same as used for thumb sucking), or 
using the ‘‘Elbow Cuff.’’ 

Paragraph 829 

NORMAL SIZE OF THE HEAD AND CHEST. The follow¬ 
ing is the size of the baby’s head and chest: 

Head Chest 


Birth . 

....13% 

inches. 

...13 

inches 

Six months.... 

....17 

4 4 

...16% 

4 4 

One Year. 

....18 % 

4 4 

...18 

4 4 

Two Years .... 

....19 

4 4 

...18% 

4 4 

Three Years 

....19V2 

4 4 

...20 

4 4 

Five Years.... 

....21 • 

4 4 

...22 

4 4 

Adult life.... 

....21% 

4 4 

...30 

4 4 


Paragraph 830 

NUMBER OF PULSE BEATS. The number of 
child’s pulse beats per minute is a follows: 

At birth.130 to 150 

First month .120 to 140 

1 to 6 months.about 130 


1 to 2 years.—. 

2 to 4 years..... 
6 to 10 years.. 
10 to 14 years 
Adult life. 


,110 to 120 
90 to 110 
...90 to 100 
. 80 to 90 
. r . 72 


Page Three Hundred Twenty-six 
























TRAINING OF INFANTS AND CHILDREN 


This table gives the pulse rate in children 
who are awake and perfectly quiet. The figures are 
even more approximate than in the case of respira¬ 
tions, owing to the great tendency to irregularity 
referred to, and to the extreme difficulty experi¬ 
enced in finding the quiet state desired. For this 
reason the best time to count the pulse is when the 
child is asleep. We must remember, however, that 
sleep produces a decided decrease in speed. In 
children under 9 years of age, the decrease is 16 
to 20 beats per minute; from 9 to 12 years, it is 
about 8 beats, and from 12 to 15 years, 2 beats. 

The rapidity of the pulse is slightly greater in 
girls than in boys of equal age, but the difference 
is not very material. 


Paragraph 831 

NUMBER OF RESPIRATIONS. The number of a 
child’s respirations per minute is as follows: 

At birth, and for the first two or three 
weeks, 30 to 50, average about 40. 

During the rest of the first year, 25 to 35, 
average about 30. 

1 to 2 years, about 28. 

2 to 4 years, about 25. 

Adult life, 16 to 18. 

All these rates are from one-fifth to one- 
quarter less when the child is asleep, at least up 
to the age of four years, although after this the 
breathing is still slightly slower during sleep. 
The numbers given are average and approximate ones 
only, for the rates vary considerably in young 
children. To estimate the frequency of the breath¬ 
ing, we may watch the in-and-out movements of the 
abdomen, or perhaps put the hand lightly on the 
abdomen and feel them. It is necessary to avoid 
the slightest excitement, since this increases the 
rapidity very greatly. During sleep is an excel¬ 
lent time for making the observation, allowing for 
the differences mentioned. 

Paragraph 832 

CORRECT DOSE. To know the correct dose of 
medicine to be given to children according to its 


Page Three Hundred Twenty-seven 


LECTURES OF INTEREST TO WOMEN 


age, Dr. Young’s rule is a good one. It is as fol¬ 
lows: Add 12 to the child’s age and divide the re¬ 

sult by the age of the child; that is, if a child 
is 4 years old add 12 to 4, which would be 16; then 
divide 16 by 4, which would be 4, or h; that is, a 
child 4 years old would be given H as much as an 
adult. This is for the ordinary drugs. Those 
that have a poisonous or toxic effect must be given 
in still smaller doses, and only as prescribed by 


the physician. The following is a table of propor¬ 
tionate dosage at different ages: 

Adult .1 

18 years..3/4 or 1 

12 years.1/2 

8 to 10 years.....2/5 

6 years.1/3 

4 years.1/4 

3 years.1/5 

2 years...1/7 

1 years.1/10 

9 months . ,.1/15 2/3 dose of 1 year 

6 months...1/20 1/2 dose of 1 year 


Birth to 3 months....l/30 1/3 dose of 1 year 


Paragraph 833 

AVERAGE DOSE. 

The following is the scale of doses employed 
at Guy’s Hospital, London, one being the unit or 
adult dose: 


AGE— DOSE 

1 month .1/20 

3 months ..1.1/15 

6 months . 1/10 

9 months .1/9 

1 year.1/8 

2 years . .....1/7 

3 years . 1/5 

4 years . 1/4 

5 and 6 years.1/3 


AGE— DOSE 

7 and 8 years.1/2 

10 and 12 years...2/3 

13 and 15 years.3/4 

18 to 20 years...5/6 

21 to 45 years. 1 

50 years .5/6 

60 to 70 years.3/4 

80 to 90 years.2/3 

100 years . 1/2 


Paragraph 834 

SNAKE BITES. 

To be effective, treatment must be given im¬ 
mediately. Tie two tight bands, one above the other, 


Page Three Hundred Twenty-eight 
































TRAINING OF INFANTS AND CHILDREN 


the same as directed for mad dog bites. Take a knife 
and open up the wound freely in several different 
places, and thoroughly suck out the poison. To do 
this, the lips should be free from any sores or 
cracks. Give whiskey in large quantities, or any 
other strong stimulant. 

The local treatment for such cases is to ex¬ 
cise the wound, or cauterize it with a hot iron. If 
possible, secure medical aid. The bands may be left 
on for a few minutes and re-applied. The wound should 
be washed with an antiseptic solution, such as 
alcohol, bichloride 1-1000, or permanganate of 
potash, 20 grains to the ounce. 

Paragraph 835 

CAT, DOG OR HORSE BITES. 

Children are often bitten by animals in play, 
and oftentimes when the animal is cross. When the 
skin is broken the parts should be thoroughly dis¬ 
infected at once. The wound should be washed off 
thoroughly with bichloride solution (1-2000), 
then with a lysol solution (1-400); next wash the 
parts off thoroughly with plain boiled water, and 
lastly apply a turpentine dressing; that is, pour 
turpentine on the parts and wrap them up in gauze 
which has been slightly moistened with turpentine, 
and put the dressing in place, not too tight, or it 
will blister. In place of the turpentine, you 
may use alcohol. Such bites are not serious unless 
the animal is mad, or the wound becomes infected. 

When a child is bitten by a mad dog on the 
hand, forearm, foot or leg, the thing to do is to 
act quickly, and prevent the poison from entering 
the system. This is done by tying a strap, cord, 
rope or handkerchief, or anything that will make a 
tourniquet, and tie it tightly, to control the circu¬ 
lation of the blood, practically stopping it. If 
the bite is on the hand, bind the cord tightly around 
the hand just above the wrist; if on the forearm, 
then tie it tightly around the arm just below the 
arm pit; if the bite has occurred on the foot, or leg 
below the knee, tie the band tightly just above the 
knee; if the bite has been just above the knee, tie 
the band tightly around the thigh. 


Page Three Hundred Twenty-nine 



LECTURES OF INTEREST TO WOMEN 


Paragraph 836 

In the treatment of a mad dog bite, the band 
must be placed as quickly and tightly as possible. 
One or two bands can be tied (one above the other), 
as two would be more successful than one. Leave 
these bands or bandages on for an hour, release 
them for a few minutes, and renew again if neces¬ 
sary. Treat the wound locally by swabbing it out 
with full strength carbolic acid or iodine, then 
apply a piece of gauze saturated with pure alcohol. 
Make all haste to get the patient within reach of 
the proper medical assistance. 

If it is suspected that the dog is mad, it 
should be confined in a safe place for four or five 
weeks to see if it develops hydrophobia. 

Paragraph 837 
MOSQUITO BITES. 

Mosquitoes are a source of great annoyance 
to infants and children, and the little pests must 
be kept away. They often carry infection. Windows 
and doors.should be screened, and mosquito-bar 
should be so arranged over the baby’s bed that it 
will keep the mosquitoes out. 

The itching is best .controlled by ammonia, 
or spirits of camphor. Dampened salt on the spot is 
sometimes useful; also Calvert’s carbolized oil, 
which is made by using a half a teaspoonful of pure 
carbolic acid and two ounces of the finest olive 
oil. This preparation should be marked ‘‘Poison.’’ 
It can be applied to the parts bitten by mosquitoes. 

Paragraph 838 

INSECT STINGS. 

Insect stings from bees, etc., are seldom 
dangerous, yet quite painful. The parts should 
first be washed with alcohol, and if the sting of 
the insect is present, it should be removed. 

Ammonia water and spirits of camphor is applied, * 
after which a poultice of antiphlogistine is 
useful. 

Paragraph 839 

MUSCULAR CRAMPS. 

Cramps in the muscles occur mostly in adults, 
and generally come in the calf of the leg. They are 


Page Three Hundred Thirty 


TRAINING OF INFANTS AND CHILDREN 


prone to appear at night, and are often very annoy¬ 
ing and painful. At times, the frequency of re¬ 
currence of these cramps are of such a painful 
character as to seriously interfere with sleep. 
They occur in various conditions, like diseases of 
the kidneys and pregnancy. 

In children, we get more or less twitching of 
the muscles in acute intestinal infection. When 
cramps occur they should be massaged vigorously. 

The patient can press the toe against the foot of 
the bed; or stand on the floor and rest the weight 
partially on the ball of the foot of the affected 
leg. This will generally relax the muscles and 
relieve the crampy condition. If it should occur in 
children, grasp the foot and toes and press toward 
the body; at the same time massaging the contracted 
or twitching muscles. As a general rule, the cramp 
lasts only a short time, but often leaves the muscles 
sore and tender for ten or twelve hours. 

Paragraph 840 

BURNS IN CHILDREN. 

Children get burned very frequently in vari¬ 
ous ways, which produce very slight or very serious 
conditions. The usual causes are hot water, steam, 
acids, or some of the alkalies. Burns are classified 
into first, second and third degree, according to 
the severity of the burn. Some cases cause fever and 
rapid pulse. Burns always cause more or less pain 
and shock. It all depends upon the amount of surface 
involved, the condition of the child, and the degree 
of the burn. Burns of any magnitude should be con¬ 
sidered seriously on account of the risk of infec¬ 
tion and degree of shock. 

Paragraph 841 

There are three preparations, one of which 
every mother should have on hand to use in a case of 
emergency until the physician arrives. The first 
one is equal parts of linseed oil and lime-water. 
Apply this freely on a cloth. Another preparation 
is an ointment known as Unguentine. This should be 
applied in sufficient amount to exclude the air, 
and a light bandage put on. The other is an ointment 


Page Three Hundred Thirty-one 



LECTURES OF INTEREST TO WOMEN 


of one per cent picric acid, applied the same as the 
Unguentine. The picric acid can be used in a one 
per cent solution in the same way as the linseed oil 
and lime-water is used. 

Paragraph 842 

NOSE-BLEED. 

Nose-bleed is controlled by placing the hand 
and forearm over the top of the head on the side that 
the hemorrhage occurs, then press firmly along the 
side of the nose (the same side that is bleeding) . 
This will often control the bleeding in a very short 
time. The arm over the head decreases the blood 
pressure on the nose, and the pressure on the nose 
will act locally to control the hemorrhage. 

If this fails give the child a mustard foot 
bath. Syringe the nose out with a solution of tannic 
acid—dissolve 2 teaspoonfuls of tannic acid in 2 
ounces of water, and add 1 teaspoonful of glycer¬ 
ine. If this is not effective, apply adrenalin so¬ 
lution (using 1-1000) , 1 dram and 2 drams of boracic 
acid solution or sterile water; drop from 3 to 5 
drops in the nostril, or it may be applied on a 
cotton applicator. Be sure the cotton is well 
wrapped on the applicator, so it will not remain in 
the nostril when the applicator is removed. This 
may be repeated in five or ten minutes if neces¬ 
sary. Be careful and never blow the nose during 
the bleeding, and for some time afterwards. 

Paragraph 843 

WARTS. 

Warts are very common in children, generally 
appearing on the hands. They develop quite rapidly 
and disappear in the same manner without any 
treatment whatever. There is a belief that they are 
destroyed by various charms, but we have no real 
evidence that any such procedure will cause their 
disappearance. 

TREATMENT. The most scientific treatment for 
the removal of warts is to destroy the fungus growth 
with the application of electricity, applied in the 
form of the high frequency current. It requires 
special electrode, which produces a single spark. 


Page Three Hundred Thirty-two 



TRAINING OF INFANTS AND CHILDREN 


After the wart has been treated several times with 
the electrical spark, it turns black, then it is 
curetted out and the wound soon heals, leaving the 
skin perfectly smooth and clean. 

While the mother will not be able ,to apply this 
treatment, the services of a physician familiar 
with such work can always be secured. 


Paragraph 844 

SUNBURN, 

When the skin becomes irritated from the sun 
rays, it becomes red and tender, often swollen and 
blistered, and when exposed to the sun it will cause 
much discomfort. The ordinary sunburn causes very 
little trouble. Fresh air and sunlight are to be 
recommended rather than discouraged, as regards 
discoloration of the skin. 

TREATMENT. The treatment of sunburn, when it 
is severe, is the application of a soothing oint¬ 
ment, and one of the best is oxide of zinc ointment. 
This can be purchased from the druggist in tubes, 
and should be applied freely. 

Paragraph 845 
FRECKLES. 

Freckles are caused generally from the sun 
rays. People with light complexion, like blondes, 
or red-haired persons with delicate skin, are very 
susceptible to freckles. They occur most frequently 
after the third year and until puberty. When they 
do develop, they generally disappear after that 
time. Children who have skin, on which freckles 
develop easily, could possibly prevent them by not 
exposing themselves to the sun, but this is not to 
be recommended, as it would injure their health. It 
is only a question of time when freckles will 
disappear of their own accord. The girl should shade 
her face, and protect it from the intense sun rays, 
by wearing a broad brimmed hat. 

TREATMENT. The best treatment for freckles is 
some soothing preparation, and the treatment is 
effective to a more or less degree. It is not 
advisable to use, indiscriminately, the various ap¬ 
plications sold in the shops for such conditions. 


Page Three Hundred Thirty-three 


LECTURES OF INTEREST TO WOMEN 


The safest preparation is a benzoine compound, 
which is made by taking the tincture of benzoine, 1 
teaspoonful; glycerine, half a teaspoonful; rose 
water, enough to make three ounces. Apply this 
locally threg or four times a day. 


Paragraph 846 

BIRTH-MARKS. 

Birth-marks often occur in the form of moles 
and naevi. The latter is the technical name for 
the reddened or purple circumscribed area on the 
skin. Sometimes this reddened condition is on a 
level with the skin; other times it is elevated. It 
is generally very small, but sometimes it is very 
extensive. When an excessive growth develops, 
which is very rare, it may prove a dangerous condi¬ 
tion, but generally speaking, it receives no 
attention, and is of no consequence, only the un¬ 
sightly disfiguration which it produces. 

Birth-marks are not caused by any impressions 
made upon the mind of the mother during pregnancy, 
and they rarely need any treatment. It may be 
necessary to remove some on account of the looks; 
this will need an operation; others cannot be removed 
at all. 

f 

Moles are of frequent occurrence. This is an 
elevated part of the skin, and often dark in color. 
Sometimes they are flat; they may be smooth or 
they may be covered with hair. They vary in size; 
being very small, or of sufficient size to cause 
more or less disfigurement. When moles are located 
on the face, they can be removed by surgical 
operation. 

Paragraph 847 

TONGUE-TIE. 

When this condition exists, there is a mem¬ 
brane in the middle of the tongue, extending so far 
forward on the tongue that it holds it back in the 
mouth, which interferes with the free action of the 
tongue and nursing. The frenum, or membrance, is 
divided by clipping it with a blunt-pointed scis¬ 
sors, which is done by a physician. 


Page Three Hundred Thirty-four 




TRAINING OF INFANTS AND CHILDREN 


In order to prepare the child, wrap it in a 
large towel, binding its arms to its sides. It is 
placed on its back in the mother’s or nurse’s lap, or 
better still, on the table. The head should be 
supported by the nurse, and the child held by an as¬ 
sistant* which will leave the physician with both 
hands free for the operation. 

The instruments that you will need to steri¬ 
lize for this operation are a pair of blunt-pointed 
scissors and a grooved director. The broad end of 
the grooved director is placed under the infant’s 
tongue. The membrane is fixed in the slit of the 
grooved director. This raises the tongue and keeps 
it out of the way, and puts the membrane to be cut on 
a tension. The cutting of the membrane is a simple 
matter, and the bleeding is so slight that it need 
not be considered. 

Paragraph 848 

HARE-LIP. 

Fortunately, such a condition as hare-lip is 
not very common, but when the lip does not unite 
properly, and forms a division, it requires an 
operation. Surgeons differ as to the proper time to 
operate. As a rule, these cases are not operated on 
until after the child is two years old. During 
the hot summer months is not a good time to operate 
on young infants, as it requires more effort at 
this time to overcome the shock of the operation, 
and there is also more danger of stomach and bowel 
complications if the weather is hot. 

Giving the child sufficient nourishment until 
conditions are favorable, is not to be dreaded, 
because we have ample facilities for feeding a child 
with hare-lip. This is accomplished by using 
forced feeding, or gavage, which is fully explained 
elsewhere. See ‘‘Forced Feeding.’’ 

A condition often associated with hare-lip is 
a cleft palate, which is an opening through the 
palate; the mouth and nose forming one cavity. It 
interferes with nursing, and makes it impossible by 
taking away the power of suction. Such a case must 
be fed from a spoon, or by forced feeding. There 
is a specially made nipple, in which there is a 


Page Three Hundred Thirty-five 


LECTURES OF INTEREST TO WOMEN 


thin rubber flap, or plate, made to act as a false 
palate, and closes the unnatural opening during 
the nursing. This is used until after the nursing 
period, or until the case is ready for operation. 

Paragraph 849 
NIGHT TERRORS. 

We often find night terrors in children from 
two to six years old, who have some derangement of 
digestion or nervous temperament, and oftentimes 
the evening meal, previous to the attack, was far 
beyond the digestive capacity of the child. Some¬ 
times overwork at school will cause night terrors; 
also over-excitement of any kind; such as, birthday 
parties, Christmas nights, heavy meals in the 
evening. Often children suffering with adenoids, 
enlarged tonsils, or pinworms, are subject to 
night terrors. 

They come on suddenly during the sleeping 
hours. The child screams and is overcome with 
fright, stands up in bed, and often runs from the 
room, does not seem thoroughly conscious, fails to 
recognize its parents, and often cannot be pacified. 
They generally come on about two or three hours 
after the first sleep and last but a short time. 
Usually only one attack occurs during the night. It 
generally occurs at irregular intervals, depending 
upon when the child was excited or overfed. 

Paragraph 850 

NURSING TREATMENT. A child suffering with 
terrors should have its diet carefully guarded. It 
should have its dinner at noon, and the evening 
meal should be very light; consisting of a little 
stewed fruit, milk, toast and butter, and some 
kind of cereal. The child should never be allowed 
to go to bed unless the bowels have moved freely 
at least once during the previous twenty-four hours. 
School duties should be lessened, and excitement 
of any kind should be forbidden. 

Paragraph. 851 

HEADACHE. 

In the treatment of headaches, that are gen¬ 
erally caused from some derangement of the stomach, 


Page Three Hundred Thirty-six 


TRAINING OF INFANTS AND CHILDREN 


it is best to give a dose of saline laxative or a 
bottle of citrate of magnesia. In two or three hours 
after taking the laxative, give a saline enema, and 
see that the alimentary canal is thoroughly emptied. 
Take but very little nourishment, mostly liquids, 
and take the migraine tablets as directed--one every 
fifteen to thirty minutes for adults, and for chil¬ 
dren 12 years of age one every two or three hours 
until relieved. You may give a child one every hour 
for a dose or two. Cold or hot applications applied 
to the head, with a hot mustard foot bath will be 
found very good treatment for headaches. 

Paragraph 852 

EARACHE. 

Inflammation and discharge from the ear is 
very common in children, causing earache and pains 
in the ear. They are diseased conditions affecting 
the middle ear, and abscesses form in the mastpid 
cells back of the ear, which require the attention 
of a specialist. But nine times out of ten, earache 
in children is due to neglected colds. The pain 
may come on suddenly (often in the night) with no 
distinct symptoms present. 

When a child has earache, and at the same 
time there is a discharge from the nose, we have 
reason to believe the ear is inflamed. A child a 
year of age or over will put its hand to its ear; 
small infants merely cry loudly and almost con¬ 
tinuously. The pain may continue for a few hours 
or days. 

Paragraph 853 

NURSING TREATMENT : You will give the child 
great relief by gently syringing the ear out with 
warm boracic acid solution. The child should be 
placed on the infected side, with the head down¬ 
ward over a basin and, with the ear syringe, the so¬ 
lution should be gently forced into the canal, 
but do not place the syringe too far into the ear 
so as to obstruct it. 

The ear should be dried with a cotton appli¬ 
cator. Extreme care should be taken not to injure 
the ear drum. Do not insert the applicator too 


Page Three Hundred Thirty-seven 


LECTURES OF INTEREST TO WOMEN 


far. When the ear is dry, put in a drop or two of 
warm glycerine; close the canal with a little 
cotton. 

When pus forms behind the ear drum, rupture 
of the drum will follow; this will give relief and 
the pus will escape from the ear. This often occurs 
before the condition is detected by the mother, 
nurse or physician. The canal should be thoroughly 
cleaned out with boracic acid solution, using the 
ear syringe; avoid using force. The canal should 
be dried and the outer ear lightly packed with 
cotton. 

In place of using the boracic acid solution, 
the ear may be irrigated with a 1-10,000 bichloride 
solution, using an ordinary fountain syringe with 
a straight medicine dropper attached. A large 
amount of hot solution can be used in this way (a 
quart or more) , and when there is much discharge it 
is the best treatment. When irrigating the ear 
in this way, the child may be sitting up, and place 
a basin under the ear to catch the solution. Never 
use any kind of powder in the ear. 

Sometimes there may be an accumulation of 
wax in the ear, which should be removed, and the 
best thing to soften up the wax, so that it can be 
washed out with boracic acid solution, or wiped 
out with small cotton applicators, is to put into 
the ear, with a medicine dropper, a drop or two of 
warm glycerine. 

Any further treatment, than the above men¬ 
tioned, should not be attempted by the mother or 
nurse. Do not get into the habit of placing dif¬ 
ferent medicines in the ear to stop the earache. 

Hot applications and washing out the ear with warm 
boracic acid solution, removing the wax 
with glycerine, and irrigating the ear with 
bichloride solution, should be all that any mother 
and nurse should do without the advice of a 
physician. 

When the earache continues, and the child 
has a temperature, and the above treatment fails to 
give relief, pus may be forming, and the ear drum 
may need lancing. See the specialist. 


Page Three Hundred Thirty-eight 



TRAINING OF INFANTS AND CHILDREN 


\ 


Paragraph 854 

RINGWORM. 

Ringworm is a contagious skin affection, 
which occurs mostly in childhood. It occurs on the 
face or any part of the body, but only found on the 
scalp in childhood. It consists of a single, dull- 
red, more or less circular spot, which gradually 
enlarges in size until the center becomes almost 
natural in color and appearance, and leaves an in¬ 
flamed ring around the edge. When ringworm occurs 
on the scalp, the patches are more numerous, cir¬ 
cular, but not very red. The hair often comes out in 
the center of the ring, leaving the spot bald. 

In a case of ringworm, a child should be prac¬ 
tically isolated until it is cured. It is a mother’s 
duty to see that the child does not come in contact 
with other children, thus preventing them from 
catching it. A child must not attend school, and all 
its toilet articles must be kept strictly for its 
own use. 

Paragraph 855 

TREATMENT. Paint the affected parts once a 
day with iodine; or a sulphur and tar ointment, 25 
per cent each, well rubbed into the affected parts 
two or three times a day, for a week or longer, will 
often effect a cure. Yet the treatment of ringworm, 
especially in the scalp, is very difficult, and the 
wise mother or nurse will not undertake to care for 
a case herself, and the sooner the skin specialist is 
consulted, the greater the chance of getting it 
under control. 

Paragraph 856 

LICE. 

Lice occur in all classes, and they are con¬ 
tracted from some accidental contact with a person 
infected, and when they are discovered in the scalp, 
the first symptom is a severe itching. The lice 
themselves must be removed, and the nits destroyed. 

Paragraph 857 

TREATMENT. The best way to destroy the nits 
and remove the lice is to apply kerosene to the scalp 
and thoroughly wash the scalp with tar soap to re¬ 
move the kerosene. Between the applications of the 


Page Three Hundred Thirty-nine 





LECTURES OF INTEREST TO WOMEN 


kerosene, which should be every other day, the hair 
should be washed with vinegar in order to destroy 
the nits. With this kind of treatment, long hair 
need not be cut off. One of the best ointments to 
use is made from larkspur seed. A 50 per cent oint¬ 
ment is generally used, and is rubbed on the scalp 
several days in succession. This ointment is very 
effective, killing both the lice and the nits. 


Paragraph 858 
ITCH. 

Itch, the same as lice, may affect the indi¬ 
vidual, as it is transmitted by personal contact. 
It consists of small pimples, and may occur on any 
part of the body. The itching sometimes is very in¬ 
tense, and the skin is actually torn by scratching. 
The itch may be contracted from bed linen or cloth¬ 
ing, and special attention must be given to disin¬ 
fecting the clothing and bedding. 

Paragraph 859 

TREATMENT. The treatment consists of giving 
a bath with liquid green soap, and applying freely 
a 50 per cent sulphur ointment night and morning. 
The green soap bath should be given once or twice a 
week. 

Paragraph 860 

BOILS.’ 

Boils are very common, and are very painful. 
Within a circumscribed area, the skin becomes ele¬ 
vated, red, tender, and swollen, which part becomes 
filled with pus. Boils are generally associated 
with some unfavorable hygienic conditions, or some 
impaired condition of the health, which may be gen¬ 
eral, or a local disturbance. 

Paragraph 861 

TREATMENT. The best preventive treatment 
(to prevent a boil from forming) is: when the first 
pimple develops, which gives evidence of the forma¬ 
tion of a boil, apply a piece of gauze to the in¬ 
flamed part, well vaselined on the side placed next 
to the skin, and make the gauze quite moist with 
chloroform. Add a little chloroform from time to 
time to keep the gauze moist. If this treatment is 


Page Three Hundred Forty 




TRAINING OF INFANTS AND CHILDREN 


properly applied, it will often abort a boil or car¬ 
buncle. Care must be taken that too much chloroform 
does not come in contact with the skin that is un¬ 
protected with vaselined gauze, as it may cause a 
blister. 

If chloroform does not stop the infection, 
and it goes on to the formation of a boil, then the 
best treatment is to apply a saturated solution of 
Epsom salts. This is done by wringing out a piece 
of gauze in a hot solution of the salts and placing 
it to the parts. Wring out a Turkish towel in plain 
hot water and apply it over the gauze, and on top of 
the towel place a hot water bottle, but do not have 
the water sufficiently hot to burn the skin. It 
should be washed off carefully with pure alcohol, so 
as to render the parts thoroughly aseptic. In a 
great many cases it is necessary to have the boil 
lanced, and in such cases it will be necessary to 
consult a physician. 


Paragraph 862 

DANDRUFF. 

Unless a great deal of care is given to the 
scalp, young infants will often develop an exces¬ 
sive production of dandruff, and scales form on the 
scalp. This should not be allowed to form, and may 
be prevented, as recommended by Griffith, by apply¬ 
ing a 10 per cent boric-acid ointment daily to the 
scalp with a moderate amount of friction. This will 
check the excess of oily secretion. When large 
yellow patches form, they should be removed by 
soaking with sterile warm olive oil; then wash it 
with pure Castile soap and warm water. Dry the parts 
thoroughly and apply the boric-acid ointment twice 
a day. Never use a fine tooth comb to remove crusts 
or yellow patches. 

Paragraph 863 

INTESTINAL WORMS IN CHILDREN. 

There are three kinds of intestinal worms 
that occur in children: the round worm, the pin- 
worm, and the tapeworm, and they probably occur in 
frequency as mentioned. Worms produce very in¬ 
definite or no symptoms, and a great majority of 
mothers think their children have worms when they 


Page Three Hundred Forty-one 



LECTURES OF INTEREST TO WOMEN 


are not suffering from them at all, but have some 
diseased condition of the digestive organs. 

Merely because a child has a loss of appetite, 
grinds its teeth at night, is restless, picks its 
nose, or has dark circles under the eyes, is no 
reason why a child should be dosed with various kinds 
of vermifuge or ‘‘Worm Medicines’’ that are on the 
market, because abnormal digestive conditions will 
produce identically the same symptoms. 

Just how the pinworms and round worms are 
acquired is not proven with absolute certainty. 

The tapeworm enters the body in food containing the 
eggs or ovum, such as pork, beef and fish. We will 
consider the three kinds of worms in their order of 
frequency as they occur in children. 

Paragraph 864 

ROUND WORM. The round worm is reddish or 
yellowish in color, and is usually from five to ten 
inches long. The male worm is smaller than the 
female. They are found in the small intestines and 
always in numbers, probably from half a dozen to a 
dozen in each case. Some authors state that from 
200 to 300 have been found at one time. This worm 
is usually found in children between the second and 
tenth years. It is never found in nursing children. 

They sometimes get into the stomach from the 
small intestines, and cause sufficient irritation 
of the stomach to produce vomiting, and the worms 
are often expelled with the contents of the stomach. 
They have wonderful wandering facilities and may 
enter into various parts and cavities of the body, 
such as the vermiform appendix, gall bladder, throat, 
trachea (wind pipe), stomach, middle ear, or nose. 
The round worm causes restlessness at night, grind¬ 
ing of the teeth, picking at the nose, colic, or 
diarrhea. The nervous system is irritated sometimes 
to the extent that convulsions will occur. 

It is important to remember that these signs 
and symptoms do not always mean worms. The diagnos¬ 
tic proof is to find the worms in the stool, and 
when they are present some of them will invariably 
be passed. To make a positive diagnosis, the ovum 
must be discovered in the stool by a microscopic 


Page Three Hundred Forty-two 



TRAINING OF INFANTS AND CHILDREN 


examination, which is very necessary, and should 
always be made when the child has symptoms as men¬ 
tioned above, and you suspect it has worms. 


Paragraph 865 

PINWORMS. Pinworms are much different from 
the round worms. They look like a short piece of 
white thread and are from one-third to one-half 
inches long. They taper towards the tail. The female 
is a thin yellowish white worm and has a pointed 
tail. The male has a strongly curvel tail. They 
inhabit the lower part of the bowel in and around 
the rectum, and sometimes they wander into the 
vagina. 

They are usually found in large numbers, and 
are very irritating to the mucous membrane of the 
bowel, causing catarrhal condi-tions. They cause 
intense itching of the rectum, which is always worse 
at night after the child becomes warm in bed. It 
seems as though the worms are most active at this 
time. The intense itching caused by the pinworms 
about the anus and adjoining parts is one cause of 
the bad habit of masturbation. The nervous system 
is irritated to some extent but not as severe as that 
caused by the round worms. 

To remove the pinworms, first thoroughly 
cleanse the bowels out with a copious injection of 
warm water, then inject an infusion of quassia. This 
infusion is made by taking quassia chips and steep 
them the same as making tea. After straining out 
the sediment, use the solution as an enema, and let 
it remain in the rectum as long as possible, using 
just a sufficient amount (2 to 4 ounces) so that 
the bowels will retain it for some time. Do not use 
enough to distend the bowels so that it will be ex¬ 
pelled immediately. After the quassia enema has 
been retained for half an hour give a large enema of 
the quassia solution and have the entire amount 
expelled. 

Paragraph 866 

TAPEWORM. A tapeworm does not occur as fre¬ 
quently in children as it does in adults, and the 
form that occurs most frequently is the one found in 


Page Three Hundred Forty-three 




LECTURES OF INTEREST TO WOMEN 


beef. The tapeworm develops in about three months, 
when the large segments separate and are discharged 
in the stool. Each segment contains both male and 
female organs, therefore each segment is capable of 
producing a whole worm, and for this reason the 
treatment will be unsuccessful unless the head and 
all other segments have been expelled. 

Tapeworms live a long life—from 10 to 20 
years, and some say as long as 30 years. The length 
of a tapeworm varies from 10 to 15 feet. When chil¬ 
dren have a tapeworm, they have more or less nervous 
trouble, are restless, breath is foul, and appetite 
varies. Even when the appetite is good the body 
continues to waste, and the child becomes anemic 
and has the appearance of a child suffering from some 
form of tuberculosis. The only positive way of tell¬ 
ing if a tapeworm is present is when segments of the 
worm are'found in the stools. 

Paragraph 867 

TREATMENT. The treatment of the round worm 
and tapeworm should be under the care of the physi¬ 
cian, who should have charge of the child in both 
cases and give such orders as are required in each 
case. The treatment of the pinworm is very effec¬ 
tual and they are easily removed by the use of medi¬ 
cated enemas, which can be given by the mother with 
very good results. 

Paragraph 868 

NOTE—Now remember, do not attempt to pre¬ 
scribe for, or give a child any kind of worm medicine 
in any case of suspected round or tapeworms until . 
directed to do so by the family physician, because 
the treatment of these conditions is beyond the 
skill of the mother. 


Paragraph 869 

INFECTION OR BLOOD POISON. 

An infection is the result of some form of 
germ poison entering an injured condition of the 
skin, or mucous membrane, which leaves an open 
wound. After the wound becomes infected, there is 
generally more or less inflammation, which causes a 
series of local changes in the tissue; this con¬ 
stitutes the infected reaction to injury. 


Page Three Hundred Forty-four 




TRAINING OF INFANTS AND CHILDREN 


The tissue most liable to become infected are 
leep wounds that contain clotted blood, bruised 
tissue, and crushed wounds. These all favor the 
lodgment of germs. Healthy tissue offers complete 
protection from ordinary infection. 

Paragraph 870 

NURSING TREATMENT. When a wound is infected, 
and the surrounding tissue becomes red, inflamed, 
and swollen, associated with more or less pain; 
oftentimes red streaks running up the arm or leg, 
with the patient having one or two degrees of 
temperature, we have a condition that needs imme¬ 
diate attention. 

The wound should be thoroughly cleaned, if pus 
is present, with peroxide, and irrigated with some 
antiseptic solution, such as lysol solution 1-400, 
or chlorozene (one-tablet dissolved in a pint of 
water). The limb should be elevated, and a moist 
dressing applied. Make a saturated solution of 
Epsom salts, and have it as hot as the patient can 
stand. Wring out Turkish towels and apply them 
locally. Hot water bottles should be applied on the 
outside of the towels, in order to keep up the even 
heat. 

This should be continued night and day until 
the swelling has disappeared, and the tissue 
becomes white and wrinkled. Such hot applications 
will usually stop the infection and relieve the 
local condition. See that the bowels move freely, 
and give a light diet. 

Give internally, one teaspoonful (adult 
dose) of Echtol (Battle) every two to six hours, de¬ 
pending upon the severity of the case. Give to 
children, according to age. 

Paragraph 871 

POISONS AND ANTIDOTES 

In most all cases of poisoning, the nurse 
should use the stomach tube, and empty the stomach 
at once. The mother can produce prompt vomiting by 
using mustard whipped up in cream (2 parts mustard 
and 1 part cream), with hot water, and give a suffi¬ 
cient quantity until the patient vomits freely. 


Page Three Hundred Forty-five 


LECTURES OF INTEREST TO WOMEN 


Paragraph 872 

CORROSIVE SUBLIMATE or BICHLORIDE OF MERCURY: 

Empty the stomach with emetic; give the whites 
of six eggs; give brandy or whiskey; demulcent 
drinks. 


Paragraph 873 

CARBOLIC ACID: 

Promote vomiting; Epsom salts well diluted, 
as a chemical antidote; wash out stomach with di¬ 
luted alcohol (40 per cent), followed by water; give 
sweet oil, milk, flaxseed tea, white of egg freely 
to allay inflammation; heat to the extremities, and 
whiskey for collapse. 


Paragraph 874 

LYE AND CAUSTICS, also the ALKALIES: 

In this case do not use the stomach tube; 
promote vomiting by copious draughts of tepid water; 
give vinegar and water (equal parts), or diluted 
lemon juice (equal parts of lemon juice and water) 
to neutralize; give olive oil, white of egg, flax¬ 
seed tea. If a large amount of ammonia has been in¬ 
haled, let the patient smell vinegar freely. 


Paragraph 875 

ALCOHOL: 

Wash out the stomach with warm water and 
coffee (2 parts water, 1 part coffee), using the 
stomach tube; keep body warm and head cold, and 
have the patient inhale ammonia. 


Paragraph 876 

FLY PAPER, PARIS GREEN, ARSENIC, RAT POISON: 

Empty the stomach at once by giving mustard 
and cream with warm water every fifteen minutes 
until effective. Mix a teaspoonful of calcined 
(burned) magnesia with a cupful of water; to this 
add 3 teaspoonfuls of tincture of iron and give in 
one dose. Repeat every ten or fifteen minutes for 
three or four doses. Give olive oil and brandy, with 
raw eggs, lime water and flour and water. 


Page Three Hundred Forty-six 





TRAINING OF INFANTS AND CHILDREN 


Paragraph 877 

FISH, OYSTERS, PTOMAINES: 

Empty the stomach and give copious draughts 
of strong tea; enema to unload the bowels; lime 
water 1 or 2 ounce doses for the vomiting, and give a 
large dose of castor oil (2 ounces), hot applica¬ 
tions to the abdomen for pains. 


Paragraph 878 

SILVER NITRATE: 

Common table salt, milk, white of egg, flax¬ 
seed tea. 

Paragraph 879 

STRYCHNINE: 

Use the stomach tube, or empty the stomach 
with .mustard and cream; give tannic acid or oakbark 
tea; give antidote in starch water per rectum if 
patient cannot swallow; control spasms with ether; 
artificial respiration; amyl nitrite for inhala¬ 
tion. Keep patient absolutely quiet. 


Paragraph 880 

TOBACCO: 

Empty the stomach; keep the head low and feet 
high; large amount of warm water; strong tea or 
coffee with powdered charcoal; whiskey; keep the 
extremities warm; artificial respiration. 


Paragraph 881 

OPIUM, LAUDANUM, MORPHINE: 

Empty the stomach at any cost, and give strong 
tea or strong coffee; keep the patient awake and 
moving; brandy; external heat; artificial respira¬ 
tion. 

Paragraph 882 

MUSHROOMS: 

Empty the stomach; castor oil; copious 
enemas; brandy; keep the body warm. 


Paragraph 883 

LEAD POISONING: 

Empty the stomach; give Epsom salts; alum; 
hot fomentations to the abdomen; demulcent drinks. 


4 


Page Three Hundred Forty-seven 






LECTURES OF INTEREST TO WOMEN 


Paragraph 884 

ACETIC, HYDROCHLORIC, NITRIC, NITRO-MURIATIC, or 
SULPHURIC ACIDS: 

In these cases give no emetics and do not use 
the stomach tube; give large draughts of lime water; 
solutions of baking soda, magnesia, or plaster from 
the wall; strong soapsuds to neutralize the acid; 
olive oil, white of- egg; barley water; flaxseed tea 
to allay the inflammation. 


Paragraph 885 

IODINE: 

Empty the stomach; give plenty of boiled 
starch, strong tea, flour paste, flaxseed tea; 
amyl nitrite to the nostrils. 

NOTE—In treating a case of poisoning, the 
above instructions will apply to both children and 
adults, only reduce the amount of antidotes for 
children; call your physician and treat the case as 
directed until he arrives. 


Paragraph 886 

POISON OAK OR POISON IVY. 

In order to prevent coming in contact with 
poison ivy, and to protect children from this in¬ 
tense inflammation of the skin, mothers and nurses 
who have children under their care, should be 
familiar with the plant, and keep children away 
from it. The leaves are arranged in clusters of 
three, with smooth edges. It is often found climb¬ 
ing over fences and trees in many localities. 

The only vine that resembles ivy is the Vir¬ 
ginia creeper. The leaves are practically the 
same, only the Virginia creeper grows in clusters of 
five leaves instead of three. 

After a child comes in contact with poison 
ivy, a rash comes out in a few hours, or a day, after 
the exposure. It does not spread fast. The skin 
becomes swollen, red, hot and itchy, and is thickly 
covered with blisters from the size of a pin-head 
to a split pea. The blisters soon break and the 
water discharges, forming in dry crusts. We have 
seen children with the face so swollen that they 


Page Three Hundred Forty-eight 



TRAINING OF INFANTS AND CHILDREN 


can scarcely open their eyes. The disease lasts a 
week or longer in ordinary cases; mild cases not so 
long. 

Paragraph 887 

TREATMENT. Application of saturated solution 
of boracic acid, applied with a cloth wet in the 
solution, but see that the cloths are kept wet, and 
not allowed to dry. A very common treatment is a 
lead and opium wash, which is applied to the 
affected parts. The druggist will prepare it for 
you. It is known as the ‘ ‘black wash, ’ ’ and before 
it becomes quite dry, after applying the ‘‘black 
wash,’’ smear the surface well with oxide of zinc 
ointment. 

Paragraph 888 

FROST BITES. 

When any parts of the body are exposed to the 
cold, they become frozen, and they are quite numb, 
white and wrinkled. When warmed, the frozen parts 
become quite red, swollen and itchy. If the action 
of the cold has been very severe, blisters will form 
upon the broken surface, the tissue dies, and mor¬ 
tification sets in. Generally, unless the cold has 
been too severe, the frozen parts, under proper 
treatment, will return to their normal condition.- 
The parts regain their sensation and are very pain¬ 
ful. The swelling disappears, and there is no 
further trouble. 

Paragraph 889 

TREATMENT. The treatment of freezing con¬ 
sists of placing the patient in a cool room for 
several hours, and applying cold water to the frozen 
parts, or snow is sometimes applied. The patient 
should be rubbed with cold water, or wrapped in 
cold wet cloths. Ichthyol ointment, 20 per cent, 
may be applied to the parts after they have regained 
sensation. Great care should be taken in removing 
the patient into a warm room. 


Paragraph 890 

CHILBLAINS. 

When any part of the body becomes frozen or 
chilled, there develops a condition known as chil¬ 
blains. The skin becomes red, smooth and shiny 


Page Three Hundred Forty-nine 




LECTURES OF INTEREST TO WOMEN 


in spots, burns severely when the parts become 
warm. At times, blisters may form, and ulcers may 
develop if caused by irritation from the shoe. 
Chilblains generally occur on the feet, sometimes 
on the hands; rarely it is seen on the nose, cheeks 
and ears; especially if the parts have been frost 
bitten. Chilblains are very painful when the parts 
become warm. They are more apt to occur in children 
with poor circulation. It often develops in some 
individuals in fall and remains until the warm 
weather returns. 

The cause of chilblains is a sudden change in 
the body temperature. We often get chilblains 
when the hands and feet are very cold, and they are 
warmed quickly. 


Paragraph 891 

TREATMENT. The best treatment for chilblains 
is to dress the feet properly. A person thus af¬ 
fected, should wear easy shoes with warm woolen 
stockings, and not wear any garters that will im¬ 
pair the circulation. The stockings should be long 
enough to c.over the entire leg. If the chilblains 
affect the hands, warm mittens should be worn, so 
the hands would not become chilled. Local appli¬ 
cation of the tincture of iodine, or painting the 
parts frequently with Monsel’s solution will give 
some relief. 


Paragraph 892 

INFLAMMATION OF THE EYES. 

Colds often settle in the eyes, and the lids 
become red and inflamed. Often some infection 
or dirt may get into the eye during the child’s play. 
When a child has sore eyes, they should be 
thoroughly washed every hour or two with boracic 
acid solution, and kept perfectly clean. If this 
does not allay the inflammation, one drop of a 20 
per cent Argyrol may be dropped into the eye with 
an eye dropper, two or three times a day. Wash out 
the eyes good each time with boracic acid solution 
before applying the Argyrol. Hot packs of boracic 
acid solution, when applied to the eyes (not too 
heavy), are of value to allay the inflammation. 


Page Three Hundred Fifty 




TRAINING OF INFANTS AND CHILDREN 


Paragraph 893 

INFLAMMATION OF THE BREASTS IN INFANTS. 

In young infants of both sexes, the breasts 
often become swollen and very tender, and secrete 
a milk-like fluid. This generally occurs during 
the second and third week, and unless the tender¬ 
ness and swelling is very marked, the trouble will 
disappear in twelve to fourteen days if they are 
left alone, and will require no treatment. In some 
cases the swelling is very marked, and the breasts 
become quite red and inflamed. Such cases require 
treatment. 

Paragraph 894 

TREATMENT. The treatment consists of apply¬ 
ing hot moist dressings of a saturated solution of 
Epsom salts. Little pads are wrung out of this solu¬ 
tion and placed on the breasts during the day, and 
can be kept warm with an infant hot water bottle. 

It should not be hot enough to burn. Apply a poultice 
of antiphlogistine to the breasts during the night. 
If this treatment is faithfully applied for a few 
days, it will generally effect a cure. Never squeeze 
or massage the breasts of new-born infants. Such a 
procedure is very harmful, and may be the cause of 
producing an abscess. 


Paragraph 895 

COLDS IN THE HEAD. 

Children often have colds that affect the 
mucous membrane of the nose and throat, and when 
left untreated the inflammation has a tendency to 
extend up the Eustachian Tube to the ears, causing 
middle ear trouble. It is necessary for a mother to 
realize this fact and to give immediate and proper 
attention to such cases. 


Paragraph 896 

TREATMENT. The best treatment for a cold in 
the head is to give a good laxative and hot bath. 
Give, internally, one tablet of 1/3 grain Calcidin 
every hour for the first day, and after that every 
two hours. If there is much discharge from the nose, 
put two to five drops of liquid Albolene and Pinol- 
eum Compound in the nostrils two or three times a 


Page Three Hundred Fifty-one 




LECTURES OF INTEREST TO WOMEN 


day. This line of treatment is for a child between 
two and four years of age, and when over four years 
it should be given 1 grain of Calcidin instead of 
1/3 grain, with all other treatment the same. Give 
an enema once or twice a day in addition to the lax¬ 
ative,' in order to keep the bowels empty. 

When the cold settles on the lungs, and the 
child begins to cough, put a mustard plaster on the 
chest. In severe cases put on a mustard plaster 
twice a day, and after the mustard plaster, apply 
camphorated oil. Give, internally, for the cough 
and lungs, from % to 1 teaspoonful of Abortus sis 
every two hours; if over four years, give 1^ tea¬ 
spoonfuls. When this treatment does not give 
relief, and the child does not improve, call the 
family physician, as some complication must be de¬ 
veloping. 

Paragraph 897 

SORE THROAT. 

Sore throat often develops from the tonsils 
or mucous membrane of the throat, as the result of 
taking cold. At the beginning of a sore throat, give 
a laxative (a dose of Epsom salts, citrate of mag¬ 
nesia, or Abbott’s Saline Laxative), and see that 
the bowels move freely. A gargle for such a case 
would be Menthol Compound tablets (Abbott’s). Dis¬ 
solve one tablet in half a glass of water, and gargle 
the throat every hour or two, and this will often 
give great relief. 

If there are white spots on the tonsils, then 
it is a case of tonsillitis, requiring more exten- 
tfve treatment. The headache tablets may be given 
to relieve the headache that is generally associated 
with tonsillitis, and if there is much temperature, 
give 1 Dosimetric Trinity granule- every hour until 
the fever is gone. When sore throat is associated 
with tonsillitis in adults, the headache tablets 
and fever granules as mentioned above are given. 
When a child has a sore throat or tonsillitis, the 
gargle of Menthol Compound tablets is very bene¬ 
ficial. They can be used in any case where a child 
is able to gargle. The fever medicine or headache 
tablet must be given according to age. 


Page Three Hundred Fifty-two 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 898 

HIVES. 

Hives is a distinct peculiar rash on the 
skin, characterized by raised patches that have a 
pinkish and whitish color in appearance. They 
vary in size and look very much like insect bites. 
They often occur very suddenly and last from a 
few hours to a day. They may disappear for a day 
or a few hours and then return again. Acute cases 
of hives generally last from two to four days, 
and sometimes they become chronic. Hives in 
children are, as a general rule, associated with 
rheumatism, that is, most of them give a rheumatic 
history. 

The intense itching and burning makes a 
child very restless. Ninety-five per cent of the 
cases in children are caused by some disturbance 
in the digestive organs. Sometimes one certain 
kind of diet will cause hives; such as, straw¬ 
berries, some forms of fish, sausage, tomatoes, 
buckwheat and pineapple. It all depends on the 
individual; what affects one will not another. 

Medicines of various kinds will also cause 
hives; such as quinine, arsenic, and antipyrin. 
Diphtheric anti toxin will cause hives in about 
twenty per cent of all cases in which it is given. 
Digestive disorders of any nature, whether it be 
acute or chronic, will cause hives. Sometimes ex¬ 
ternal irritation like bites of insects, clothing 
that causes irritation of the skin, clothing that 
is too tight, or anything that irritates the skin, 
will cause hives. 

Paragraph 899 

NURSING TREATMENT. The first thing necessary 
in treating a case of hives is to thoroughly empty 
the alimentary canal. This is best accomplished 
by a full dose of castor oil, 2 to 4 teaspoonfuls 
given in orange juice. If this cannot be taken by a 
child, give calomel in one-tenth grain doses every 
fifteen minutes or half hour, until ten tablets 
have been given, and in two hours after the last 
dose, give 2 or 3 teaspoonfuls of milk of magnesia. 
When it is desired.to have the bowels move, give a 


Page Three Hundred Fifty Three 



LECTURES OF INTEREST TO WOMEN 


saline enema. Give the child plenty of water to 
drink, and reduce the diet to broths and gruels, or 
the child may have a little toast or dried bread. 
Milk should not be given in any form. 

For local application, the parts may be 
bathed with one per cent solution of carbolic acid, 
or apply a menthol cream; that is 1 grain of 
menthol to an ounce of cold cream. A bath of 
bicarbonate of soda is also soothing, and will some¬ 
times allay the intense itching and burning. 

When the laxative, restricted diet, and 
local application, as mentioned, does not relieve 
the condition, the best internal remedy is salicy¬ 
late of soda. For a child three years old, 2 grains 
of the salicylate of soda may be given every two 
hours with bicarbonate of soda; give five doses 
every twenty-four hours. The dose is increased 
according to the age of the child until 12 to 24 
grains of the salicylate of soda is given in the 
twenty-four hours. 

In obstinate cases, and when they occur 
^often, the bowels should be kept perfectly free from 
any intestinal irritation. This is best 
accomplished by giving Abbott’s Intestinal anti¬ 
septic, one grain, and peptenzyme, one and one- 
half grains, after meals and at bedtime. This should 
be continued for some time, and is the correct dose 
for a child from three to four years of age. The dose 
of intestinal antiseptic should be given according 
to age. 

Paragraph 900 

ECZEMA. 

Eczema in children is due to two different 
causes; some derangement of the stomach and 
bowels, or from some external irritation. Eczema 
occurs in children in all its combinations, and 
the changed condition of the skin is very sudden. 
Cases that originate from some internal trouble is 
most frequent and troublesome. It generally occurs 
in children from one to twelve months old, and it 
is rare for a case to develop after the nursing age. 
It may occur on the face or any part of the body. 

The physical condition of the child does not seem 


Page Three Hundred Fifty-four 






TRAINING OF INFANTS AND CHILDREN 


to exert any influence as to the case, either in 
breast-fed or bottle-fed; children may be in 
perfect health in every other respect. In treating 
such a case, our efforts must be directed towards 
the stomach and bowels. 

When eczema is caused by some local irrita¬ 
tion, the skin is usually sensitive. Sometimes 
strong soaps, vigorously rubbed, or scratchy, 
irritating clothing will cause eczema, and to 
relieve this condition, the source of irritation 
should be removed. Sometimes eczema appears where 
two skin surfaces are constantly touching each 
other, like the skin-folds of the neck, the groin, 
under the arms, and the elbow joints. 

Paragraph 901 

TREATMENT. The local treatment for eczema, 
when the cause is of internal origin, is very 
unsatisfactory. The best that can be done is to 
relieve the itching and make the child more comfort¬ 
able. As a general rule, many of the local applica¬ 
tions applied to the face soon rub off. They are 
too strong and often do more harm than good. When 
the ointment can be applied under a mask for the 
face, or when it is used on other parts of the body, 
so that it can be bandaged on, the following is of 
value: Take tar ointment (U. S. P.) 1 part, and 
ointment of rose water 4 to 6 parts. The strength 
will depend upon the irritability of the skin. This 
ointment is spread thickly upon old linen and 
bound firmly to the parts; dressings should be 
changed morning and evening. If they cause any ir¬ 
ritation, the amount of tar should be reduced. 


Paragraph 902 

A child who has eczema must have its bath, 
and the best bath to use in this case is the bran or 
soda bath. Great care must be taken to avoid irri¬ 
tating the skin by too much friction. When eczema 
is due to local causes, the source of irritation 
should be removed. 

Paragraph 903 

When eczema occurs in the folds of the skin, 
put gauze or pledgets of cotton between the parts, 


Page Three Hundred Fifty-five 




LECTURES OF INTEREST TO WOMEN 


first using powdered starch and oxide of zinc 
(equal parts) freely. The cotton should be removed 
as soon as it becomes moist, and fresh applications 
made. The diet should be regulated, and if the 
child is breast-fed, constipation of the mother, as 
well as the child, must be relieved. When the child 
is making the proper gains, nursing should not be 
discontinued on account of the eczema. 

A mother who is nursing an infant with eczema 
should give,a great deal of attention to her diet. 
She should not eat too rich food, and if she has 
been in the habit of drinking beer, tea, or coffee 
in excess, it should be discontinued, and a plain 
diet substituted. 

Bottle-fed babies, on the whole, are easier 
treated than the breast-fed, as the diet can be 
regulated in a more satisfactory manner. It is 
generally some one of the elements in the mixture at 
fault. It may be too much sugar, or too much fat 
or proteid. We reduce first one and then the 
other, until we have discovered the particular 
part of food that does not agree with the child; yet 
the food should not be reduced to such an extent 
that the infant will not receive the proper amount 
of nourishment. 


Paragraph 904 

The urine in most cases of eczema is very 
strongly acid in reaction, and it is a good plan to 
give one grain of bicarbonate of soda to each 
ounce of food. 


Paragraph 905 

In applying local dressings to eczema on the 
face, possibly the one that is mostly used is 
bassorin paste. The paste is spread on the affected 
parts and allowed to dry, which forms a protection. 
It should not be removed, but allowed to peel off; 
when this occurs a'fresh dressing should be applied. 
The face should not be washed. A half dram of oxide 
of zinc to the ounce may be combined with the 
paste. A small amount"of ichthyol or tar (half 
dram to the ounce) may also be added when a case does 
not make satisfactory progress. 


Page Three Hundred Fifty-six 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 906 

INSOMNIA OR SLEEPLESSNESS. 

This condition is generally due to being 
over-tired, pain of any kind, or intestinal trouble 
like constipation or indigestion. Oftentimes 
children sleep too much during the day, and cannot 
sleep at night; they are put to bed too early, or 
play too much just before bedtime; or in older 
children, eating too heavy a supper just before 
going to bed will cause insomnia. Poorly ventilated 
bedrooms, sometimes bright lights, covering a 
child too warmly, are all causes of wakefulness in 
a child. Such conditions should be remedied in 
order that the child may be able to sleep. 

A baby nursing too frequently during the day 
has a desire to feed often art night. Babies that 
have been handled too much, taken out for street¬ 
car rides or long auto trips, are often over¬ 
fatigued and too tired to sleep. Nervous children, 
with apparently no cause, cannot sleep, and in such 
cases it is best to give the daily bqth at bedtime, 
making it slightly warmer than usual, giving only 
a simple sponge in the morning. 

Sometimes putting older children to bed at 
rather a late hour will cause them to sleep. It 
is best not to give medicine for such conditions, 
unless it be a very simple remedy, and one that 
would be recommended by medical advice. 


Paragraph 907 
VOMITING. 

The cause of vomiting depends upon the 
functions of the stomach. When it is over-fed, or 
some irritation of the mucous membrane, or other 
various causes, whether acute or chronic, the 
stomach becomes intolerant, and vomiting is the 
result. 

Conditions not associated with the stomach 
will also cause vomiting. Any abnormal condition of 
the intestines, such as intestinal obstruction, 
will cause it. Many of the acute infectious 
diseases are ushered in, as a rule, with vomiting. 
In appendicitis in children, vomiting is usually 


Page Three Hundred Fifty-seven 



LECTURES OF INTEREST TO WOMEN 


one of the symptoms. Vomiting is also caused by 
fright, shock, over-exercise, or straining, as in 
whooping cough, or it may be purely nervousness. 


Paragraph 908 

NURSING TREATMENT. We will consider the 
management of different types of vomiting separ¬ 
ately, with the diseases and conditions with which 
they are associated. In normal cases, when the 
nursing is successful, there is more or less 
regurgitation of the milk (spitting up small 
amounts). When the nursing is unsuccessful, there 
is more or less vomiting, associated with stomach 
and bowel trouble. Especially is this true when we 
have milk that has excessive fat. 

Some infants vomit more or less during the 
nursing period, yet the child gains; is normal in 
every way, and does not seem to suffer any ill-ef¬ 
fects from the vomiting. In bottle-fed babies, when 
the food is too strong, and there is poor digestion 
and colic, vomiting, as a rule, occurs, and is 
caused by an excessive amount of fat in the food. 

Persistent vomiting is often seen in child¬ 
ren. The attack comes on suddenly, with little 
or no warning, and the contents of the stomach are 
vomited. It generally stops as abruptly as it 
began; it may last for a few hours or the entire 
day. Sometimes the attack is quite prolonged, 
lasting several days. This form of vomiting is 
often associated with rheumatic children. Do not 
give any food or water during the attacks. Nutrient 
enemas and colon flushings are used in prolonged 
cases; that is, if they last two or three days. 

These patients suffer a great deal from 
thirst, and the thirst can be satisfied by giving 
the child a pint or so of normal salt solution by the 
drop method. A child five years old often retains 
as much as two pints of fluid a day. 

It is best to begin with nutrient enemas on 
the third and fourth day. The best nutrient enema 
in this case would be four to six ounces of complete 
peptonized skimmed milk, to which has been added 


Page Three Hundred Fifty-eight 






TRAINING OF INFANTS AND CHILDREN 


the whites of one or two eggs; this is given every 
eight hours. The nutrient enemas and saline 
solution will furnish enough nourishment until the 
vomiting ceases. 

In many cases of persistent vomiting, regard¬ 
less of the cause, when children cannot retain any 
nourishment when taken by the mouth, it will be 
found that they can often retain nourishment when 
given by forced feeding, or gavage, which should be 
used. 

Paragraph 909 

ACCIDENTS. 

Various accidents occur in children, from 
getting the smallest splinter in the finger to the 
fracture of bones, including cuts and bruises. In 
removing splinters, the parts should first be ren¬ 
dered antiseptic by pouring alcohol over the parts, 
then endeavor to remove the splinter. If success¬ 
ful, disinfect the wound. Possibly the best disin¬ 
fectant is the application of turpentine. It should 
be poured over the parts; then a piece of gauze 
should be moistened with turpentine and applied, 
and the same held in place by a suitable bandage. 
Care should be taken that the turpentine does not 
blister the parts. After the first few hours the 
turpentine dressing can be removed, and alcohol 
used instead, which consists of carefully sponging 
off the parts with alcohol two or three timers a day, 
and keeping the irritated surface well protected 
with gauze dressing. 

In cases of cuts and bruises, alcohol will be 
very irritating to children, and it is better to 
clean the parts off with a weak solution of bichlor¬ 
ide 1-5000, or a Lysol solution (1 teaspoonful to a 
quart of sterile water) . If the cut surface is a clean 
surface and has no ragged edge, and the edges can be 
placed together, it should be wrapped up in the tur¬ 
pentine dressing, the same as used for splinters. 
Sometimes in cuts, the hemorrhage is quite severe, 
and gentle pressure should be used until the hem¬ 
orrhage stops before applying the dressing. 

In cases where there has been an accidental 
bruise, the skin not cut but the outer layer of skin 


Page Three Hundred Fifty-nine 



LECTURES OF INTEREST TO WOMEN 


is torn off over a certain area, the best way to 
treat such a bruise is to render it perfectly clean 
with a weak lysol solution (% teaspoonful to" the 
quart). Clean off the tissues around the bruised 
parts with alcohol; then apply locally oxide zinc 
ointment, and at each dressing the parts should be 
thoroughly cleaned, using one teaspoonful of Lysol 
to a quart of sterile water. 

In case of fractured bones, there is nothing 
that a mother can do, only place the patient in the 
most comfortable position and call for medical as¬ 
sistance at once. 

Other conditions come under ‘‘Accidents’’, 
like foreign bodies in the ear and nose. Children 
are prone to put all kinds of foreign bodies in the 
nose, and it oftentimes requires great skill on the 
part of the mother to remove them. Sometimes it is 
impossible for them to do so, and they must consult 
a physician. Do not try to push any foreign body 
into the nose or ear. If it has entered the canal 
too far, it is better to leave it alone rather than 
to resort to any further manipulation. 

Sprains are often caused by accidents, and 
sometimes are as serious, and require as long a time' 
to get well as fractures. Sprains generally require 
absolute rest, and local applications of hot com¬ 
presses will give relief until the attending physi¬ 
cian can be summoned. 


Paragraph 910 

FRACTURES. 

The first aid that a mother or nurse can give 
a child, that will add greatly to its comfort, is 
to place the fractured limb in the proper position, 
and remove the clothing. This should be done in 
an intelligent manner. The clothing should be 
removed, if possible, from the uninjured part first. 
If this is difficult, the clothing may be cut 
along the seams. 

The manipulation of the injured parts should 
be carried out in as gentle a manner as possible. 
Pull on the arm or leg, as the case may be, and place 


Page Three Hundred Si^ty 




TRAINING OF INFANTS AND CHILDREN 


the fragments as near as you can, so they will cor¬ 
respond with the opposite limb, and apply the 
dressing as directed. 

The first aid care and dressings would de¬ 
pend, of course, upon the individual bone that was 
fractured, and to consider each one separately will 
be the best way to instruct the mother as to how she 
would be of most service. Therefore, we will mention 
a few of the most common fractures. 


Paragraph. 911 

Fracture of the lower jaw. This can be held 
in position by holding the jaw up with a handker¬ 
chief, and tying the handkerchief on top of the head. 

Fracture of the collar bone. Place the arm in 
a sling. The sling can be made quickly by folding a 
piece of muslin one yard square, so as to form a 
triangle. Support the arm by placing it in the sling, 
and tie the sling around the neck. 

Fracture of the long bones of the arm above 
the elbow. The sling can be applied the same as used 
for the collar bone, and a splint of wood may be 
placed on the outer side of the arm, which is held in 
position against the chest with a bandage. This 
bandage is applied around the chest, including 
the arm. 

Paragraph 912 

Fracture of the elbow. Use the sling. 

Fracture of the arm below the elbow. Two 
splints well wrapped with cotton a little wider than 
the forearm can be applied along the back and in 
front respectively, extending from the elbow to the 
middle of the hand, tying on with a bandage or strips 
of muslin. Support the arm with a sling. 

Fracture of the ribs. The best relief that a 
mother or nurse could give such a case would be to 
bandage with a circular bandage of linen or muslin, 
applied around the chest. The bandage should be wide 
enough to extend from under the arms to the um¬ 
bilicus. This bandage should be quite firmly ap¬ 
plied and secured with safety pins. 


Page Three Hundred Sixty-one 







LECTURES OF INTEREST TO WOMEN 


Paragraph 913 

Fracture of the leg above the knee. Take a 
board long enough to extend from under the arm to 
the sole of the foot. After padding it well with 
cotton or suitable cloth (piece of an old blanket), 
it is fastened to the outer side of the limb or body 
by a number of turns of wide (four-inch) muslin or 
linen bandage. While this is being applied, trac¬ 
tion should be made upon the foot. 


Paragraph 914 

Fracture of the leg below the knee, also the 
foot and ankle. The blanket dressing may be em¬ 
ployed. The blanket splint is quickly made by fold¬ 
ing a blanket in such a manner that it extends from 
the middle of the injured thigh to below the foot. 
In order to make the splint more firm, take two broom 
sticks; cut off the proper length, and roll them up 
in a blanket, beginning with the one on one side and 
then on the other, and the broomsticks that are on 
each'side of the blanket, when rolled together, form 
a splint on each side of the leg. When the blanket is 
rolled up, it makes a sort of a trough for the limb. 
This blanket is firmly secured by tying bandages 
around the leg; one bandage just above the knee, an¬ 
other just below the knee, one about on a level with 
the ankle, and another just below the bottom of the 
foot; it being so placed that it will act as a foot 
rest and support the foot. 

A large pillow can be used in place of the 
blanket, in fractures near the ankle or foot. Hollow 
the pillow out a little in the center; pin the edges 
together below the foot, so that they act as a sup¬ 
port for the toes. This will not allow the foot to 
drop forward. Then tie a few bandages around it (.six 
inches apart), which will bring the pillow up on 
both sides of the leg and hold it quite securely. 

It is important that permanent dressings 
be applied as soon as possible, because the sooner 
the fracture is reduced the better the results will 
be, as it is easier done at that time, before there 
is any swelling of the parts, and the mother should 
secure medical aid without delay. Have the case 


Page Three Hundred Sixty-two 




TRAINING OF INFANTS AND CHILDREN 


sent to the hospital or X-ray laboratory, and have 
an X-ray photo taken. This should be done in all 
cases of fractures. 


Paragraph 915 

DISLOCATIONS. 

Dislocation of any of the various joints is a 
displacement of the particular ends of the bones 
which enter into the formation of the joint. There 
is a deformity of the joint when dislocation occurs; 
movements of the bones are usually limited, and they 
pain on motion. The child will be unable to use the 
limb to more or less extent. 

To tell the difference between a dislocation 
and fracture: In dislocation, the movements may be 
quite free, while in a fracture they are quite lim¬ 
ited. An X-ray picture should be taken in all cases 
of dislocations, and they should be treated imme¬ 
diately after they occur. 

The dressings which will be applied in a dis¬ 
location will be practically the same as for a frac¬ 
ture; that is, placing the parts at absolute rest. 
If you have a dislocation at the elbow, shoulder, or 
wrist, use a sling to support the arm. Dislocations 
at the hip, knee, or ankle, treat the same as if you 
had a fracture above or below the knee. 

Paragraph 916 

DEFORMITIES. 

Children are oftentimes born with excessive 
fingers and toes. Sometimes the last three toes are 
all the same length and size; other times the skin 
between the fingers and toes unites, forming a web 
of skin, the same as in ducks’ feet. Web-fingers or 
toes require an operation, and should be treated by 
a surgeon. 

Paragraph 917 

CLUB-FOOT. The condition known as club-foot 
may be present at birth, or it may be acquired. It 
is an abnormal shape of the foot, in which the front 
part of the foot is turned inward, and the heel is 
raised. If proper fitting braces are applied im¬ 
mediately, it will often result in a cure. Some 
cases require an operation. 


Page Three Hundred Sixty-three 



LECTURES OF INTEREST TO WOMEN 


Paragraph 918 

FLAT FOOT. Another condition, known as flat 
foot, is when the arch in the center gives away and 
the foot flattens out, and most of the foot presses 
against the ground when walking. This condition, 
causes a child to tire easily and walk awkwardly. 
Sometimes it causes pain on account of the weakened 
arch. The child should be taken to an orthopedic in¬ 
strument maker, and have the proper arch made, which 
will give the foot the proper support, or have the 
foot strapped. All such cases require medical at¬ 
tention. 

Paragraph 919 

PIGEON TOE. Another very common condition is 
pigeon-toe deformity. This is when there is an in¬ 
ward rotation of the legs, in walking. This condition 
is somewhat natural in infancy and early childhood, 
but disappears as the child receives proper training 
in walking. If it continues, have the child wear a 
pigeon-toe shoe, which is intended to turn the 
toes out. 

f 

Paragraph 920 

BOW-LEGS. Another condition of deformity is 
bow-legs. This generally results from rickets, also 
from allowing a child to stand too soon and bear its 
weight upon its feet. The mother should be very 
careful when applying the diaper, to see that it is 
not too thick between the legs, as this stretches 
the thighs too far apart, and will'cause the child to 
have bow-legs. 

A mother can do a great deal in the way of 
massaging the legs several times a day; applying 
pressure with the hands in such a manner as to have 
a tendency to straighten the curve. Sometimes this 
is very effective. There is a general tendency of 
the bow-legs to disappear as the child becomes older. 
If the simple treatment given does not effect a cure, 
it will be necessary to have braces applied. 

Paragraph 921 

KNOCK-KNEE. A condition similar to bow-legs 
is knock-knee. The cause and treatment is practic¬ 
ally the same. 


Page Three Hundred Sixty-four 




TRAINING OF INFANTS AND CHILDREN 


Paragraph 922 

HIP-JOINT DISEASE. Every mother should be 
familiar with the early symptoms of hip-joint dis¬ 
ease, because if neglected it becomes very serious. 
It is a tubercular inflammation of the hip-joint. 
When the disease first develops, the child will 
complain of pain in the knee, while the trouble is 
really in the hip. The child will start suddenly 
from its sleep, suffering with p'ain. It will appear 
lame in walking, lasting, at first, only a few days 
at a time, and if the mother be observing, she will 
notice that the child stands on the good leg and 
favors the diseased one. 

Mothers who are not familiar with this condi¬ 
tion may make a very serious mistake by thinking such 
pains are growing pains. The hip-joint disease is so 
serious a condition that the physician snould be 
consulted, and the child placed under proper treat¬ 
ment early in the disease, because recovery is very 
tedious at the best. Abscesses often form, and some¬ 
times such cases prove fatal on account of being neg¬ 
lected when they should have received proper treat¬ 
ment. 

Paragraph 923 

CURVATURE OF THE SPINE. A mother, when bath¬ 
ing her child, should examine the spine carefully at 
regular intervals, and note if there is any deform¬ 
ity. There are three principal curvatures of the 
spine: the lateral curvature, the angular curvature 
and the outward curvature. 

The lateral curvature of the spine is when 
the spinal column has a tendency to form the letter 
S. This is caused by a faulty position in sitting 
while at school, or by leaving an infant sit too long 
in a high chair when it is very young. Rickets will 
sometimes cause this condition. It is also noticed 
in older children, when they carry too heavy a weight 
with the same arm; we have seen this in boys who 
carry papers, and carry too much weight on one arm. 
The condition is a weakness of the articulations and 
muscles, which allow the bones to form such curves. 

The angular curve is due to the infection of 
the bones themselves. The bone becomes soft on 


Page Three Hundred Sixty-five 




LECTURES OF INTEREST TO WOMEN 


account of the decay, and it is generally due to 
tubercular conditions. The physician should be 
notified of such a condition at once, as it is of 
grave importance. We very rarely see this condition 
under two years of age. One of the chief symptoms is 
a tendency to fall forward when walking. There is a 
peculiar stiffness or rigidity of the back as well. 
The child gets in the habit of assuming this posi¬ 
tion in order to avoid any jarring. 

A child who has angular curvature of the spine 
does not pick things up very quickly. It does it by 
bending the knee. Pain is often felt in any motion 
of the spine, not only at the seat of the trouble, but 
often in the abdomen. The deformity is a condition 
in which the spine is straight up and down, but it 
has angles in and out, due to the diseased bone. 

The third condition of curvature of the spine 
is when the spine bows out, or the backward curva¬ 
ture. This occurs in severe cases of rickets, and is 
due to a muscular weakness which generally involves 
the whole spine. It is one round or long curve. When 
the other symptoms of rickets are cured, it will 
generally disappear at the same time. 


Paragraph 924 
RHEUMATISM. 

Rheumatism is rarely seen in children under 
two years of age. Sometimes it occurs between the 
second and fourth year, but it is more common after 
the fourth year. There is a close relation between 
tonsillitis, rheumatic infection, and many of the 
inflammatory conditions of the lungs and throat, as 
well as catarrhal inflammation of the respiratory 
tract. 


When a child suffers from rheumatism, the 
joints are not involved as frequently as they are in 
adults. We are inclined to believe that children 
suffering from muscular pains do not receive the 
detailed attention they should have; they are too 
frequently considered as growing pains. We often 
find that children who have a rheumatic inheritance 
have their share of tonsillitis and sore throat. 


Page Three Hundred Sixty-six 




TRAINING OF INFANTS AND CHILDREN 


Rheumatism is caused by the. retention of 
poison in the system, due to faulty digestion and 
poor elimination. In rheumatic children we invari¬ 
ably find one or both of the following conditions 
present: They have a history of hereditary rheumat¬ 
ism, or they are children whose food is largely com¬ 
posed of red meat. 

Paragraph 925 

NURSING TREATMENT. One of the most important 
things to do is to eliminate red meat and sugar from 
the child’s diet, or only give just enough sugar to 
make the food palatable. It is a good idea to use 
saccharine as a substitute for sugar. Give the child 
plenty of green vegetables; potatoes boiled with 
the skins on. In the way of meats, allow fish, eggs, 
and poultry. Cereals and rice are also given, and 
when oatmeal is given, it should be boiled two and a 
half to three hours. Children who have repeated 
attacks of coryza or tonsillitis, and no rheumatic 
history, should have red meat very sparingly, every 
second or third day; very little sugar; and candy 
only on rare occasions. 

When the joints become involved, much comfort 
can be afforded by supporting the affected joints 
with a cushion or pillow. Apply a moist dressing of 
lead and opium solution (U. S. P.). Warm the solu¬ 
tion, moisten the gauze, and place it over and 
around the joint; then over the gauze put some oil 
silk to retain the heat and moisture; over all a 
flannel bandage is applied. Hot water bottles should 
be placed around the outside of the flannel bandage. 
Be careful not to have them too hot. When the pain 
is very severe, these dressings should be changed 
every hour. 

Another good local treatment for inflamed 
joints is one teaspoonful of oil of wintergreen in 
an ounce of pure goose grease. This could be applied 
locally two or three times a day, with the joint 
wrapped in cotton or flannel dressings, and kept 
very warm with hot water bottles. 

It is necessary to see that the bowels keep 
regular, and an excellent anti-rheumatic, which 
has a cathartic effect, is salithia. For a child 


Page Three Hundred Sixty-seven 



LECTURES OF INTEREST TO WOMEN 


five years old, two teaspoonfuls should be dis¬ 
solved in a half a glass of water, and give the 
child a teaspoonful several times a day, or enough 
to keep the bowels moving two or three times during 
the twenty-four hours. 

Paragraph 926 

DRUGS. The two important drugs in treating 
rheumatism in children are bicarbonate of soda and 
salicylate of soda. The administration of the sali¬ 
cylate of soda can be given by the mother. She can 
get chemically pure bicarbonate of soda from the 
druggist. Give a child five or ten years old, 10 
grains two hours after breakfast and dinner for the 
first week; the second week give • 5 grains three 
times a day, after each meal (two hours after 
eating); the third week, give 5 grains twice a day 
for a week. Then omit the bicarbonate of soda for 
ten days or two weeks. After that give it twice a 
day for one week, and then omit two weeks. Continue 
giving the medicine one week and omit two weeks for 
about two or three months. 

Paragraph 927 

Proper regulation of diet, administration of 
bicarbonate of soda as directed, and local treat¬ 
ment as outlined, is a very rational and successful 
treatment for rheumatism. 

When there is rheumatic history, a special 
diet should be continued for some time, and if there 
is any sign of the rheumatism returning, the mother 
should give another course of the bicarbonate of 
soda. Now if this treatment does not prove satis¬ 
factory, and it requires the administration of 
salicylate of soda, we believe it would be wise for 
the mother to consult her family physician, in 
order to get the best results. 

The salicylate of soda is given in quite large 
doses. It has a tendency to interfere with indiges¬ 
tion, and is somewhat of a heart depressant, and 
the case while taking this should be under medical 
care. 

In conclusion, it might be well to remember 
that when a child has frequent attacks of catarrhal 


Page Three Hundred Sixty-eight 


TRAINING OF INFANTS AND CHILDREN 


conditions of the nose, throat and lungs, with no 
tonsils or adenoids, we can safely say that 
rheumatism is a caustive factor. 

Paragraph 928 
CHOLERA INFANTUM. 

Cholera infantum, or ‘‘summer complaint,’’ as 
it is often called, has a distinctive toxic origin, 
which can, in nearly every case, be traced to 
impure milk. Children who have had bowel trouble 
early in life are more apt to have cholera infantum 
in their second summer. 

The prominent symptoms of this disease are 
high temperature, profuse vomiting, diarrhea, 
stools containing mucous and blood. The yellowish, 
green-brown stools- possess a peculiar unmistakable 
odor, which once smelled will never be taken for 
anything else. 

In children suffering with this trouble, the 
prostration is extreme. The nervous system is 
profoundly depressed. A child sick only a few 
hours with cholera infantum may show all the symp¬ 
toms of exhaustion. Often convulsions occur with 
each stool. The skin becomes cold and clammy while 
the rectal temperature will be 103 to 105; eyes 
become sunken, fontanel depressed, and the mouth 
is drawn. The diarrhea and vomiting may often be 
checked only to have the little patient die from 
congestion of the brain, or profound toxaemia. 

This reminds us of the fact that it is im¬ 
portant not to mistake cholera infantum for menin¬ 
gitis. Cholera infantum requires the proper treat¬ 
ment early, in order to be successful. 

Paragraph 929 

NURSING TREATMENT. When a child is taken with 
the above symptoms, the physician should be 
summoned at once. Give a dose of castor oil. Place 
the infant in a warm bath of magnesium sulphate 
solution (one ounce to the quart); with this the 
entire body is sponged. Place into the bowel, one 
ounce of pure olive oil, to which two drops of oil 
of turpentine is added. Apply pressure on each side 

Page Three Hundred Sixty-nine 


LECTURES OF INTEREST TO WOMEN 


of the buttocks with the fingers, in order that the 
oil may be retained, and inject, very gently, into 
the rectum about a pint of warm, half strength, 
normal salt solution. The infant’s legs and 
buttocks are raised slightly so as to allow the oil 
and water to ascend. 

Now pass a large catheter, attached to a bulb 
or fountain syringe, well up into the bowel; 
through this,' one or two pints of solution of sulpho 
carbolates (40 grains to the pint) is injected into 
the intestines. The catheter is separated from 
the syringe and this fluid is allowed to run out, 
and may be repeated. This thoroughly washes the 
bowel, and any fluid remaining will serve to pre¬ 
vent further infection. In severe cases this has 
proven very successful. The child is dried well 
and wrapped in a flannel, is kept thoroughly warm, 
but in a room where there is good ventilation. 

By the time the mother or nurse has accom¬ 
plished this, the physician should be at hand to 
carry out any further medication that may be neces¬ 
sary, and give such instructions as may be required. 
The child should wear dry warm flannels, and hot 
applications should be applied to the abdomen. 

Cold may also be' applied to the head in cases where 
the temperature is high. Stop giving all food ex¬ 
cept barley water, until the case is seen by the 
physician; he will order the proper diet. 


Paragraph 930 

CHOLERA MORBUS. 

Cholera Morbus is an acute inflammation of 
the stomach and bowels, generally characterized by 
vomiting, purging and painful cramps. It is quite 
a treacherous disease, often beginning very mildly 
and occasionally terminating fatally; therefore, 
no case, no matter how mild, should be neglected. 
This condition is generally caused by over-eating 
of indigestible foods—such as unripe fruits that 
children so often eat. 

The first symptoms of cholera morbus are 
nausea, vomiting and diarrhea, consisting of large 
watery stools, often containing blood. The whole 


Page Three Hundred Seventy 




TRAINING OF INFANTS AND CHILDREN 


system becomes affected on account of the extreme 
nervous shock caused by the attack, which often 
comes on suddenly. Sometimes the amount of vomit¬ 
ing and purging is sufficient to drain the system 
of enormous quantities of fluid, which results in 
great thirst. It is very difficult to quench the 
thirst on account of the stomach not retaining 
the water, and the rectum and colon will not retain 
a sufficient amount of normal saline solution to 
attain the desired results. 


Paragraph 931 

NURSING TREATMENT. The nursing treatment 
requires absolute rest, with the child in bed, hot 
applications applied to the abdomen, mustard 
plaster to the stomach. If the child becomes pros¬ 
trate it will require stimulants. Give a dose of 
castor oil, colon irrigation, and no food except 
barley water. If the case does not improve after 
this treatment, call for medical aid. 

Paragraph 932 

< MALARIA. 

It is necessary that a positive diagnosis be 
made before a child is treated for malaria. A blood 
examination should be made- to definitely determine 
if malaria exists. The diagnosis of malaria is often 
made in children, and they are given quinine when 
the condition does not exist. The periodic tempera¬ 
ture that does not respond to quinine in full doses 
is not, as a rule, an uncomplicated case of malaria. 
Children are very susceptible to fevers of the 
periodic type, and conditions like intestinal in¬ 
fection, inflammation of the ear, pus in the plural 
cavity and grippe infections. Any one of these con¬ 
ditions may cause an elevation of the temperature, 
more or less of the periodic type, covering a con¬ 
siderable period. 

Paragraph 933 

TREATMENT. After we are positive that the 
child has malaria, quinine should be given in rea¬ 
sonably large doses. Children stand it well, and 
it must be given in larger doses than comparatively 
required for the adult. Care must be taken that it 


Page Three Hundred Seventy-one 





LECTURES OF INTEREST TO WOMEN 


does not cause vomiting. It is best given after 
meals, in solution or in capsule. A child under 
eighteen months of age will require from 8 to 12 
grains daily. 2 or 3 grains of the bisulphate may be 
given at a dose; four doses being given in twenty- 
four hours. Quinine chocolate tablets form a con¬ 
venient way to give quinine to children. It may also 
be disguised with yerba santa. The only objection 
to giving quinine chocolate tablets is that the 
child who has poor digestion may suffer by an in¬ 
crease of the trouble. The one grain of the tannate 
of quinine in chocolate tablets only represents one- 
third of a grain of the sulphate. The same may be 
said of the yerba santa, because it contains so much 
sugar. The syrup of quinine and chocolate (Merrell) 
is also a very convenient way to give quinine; each 
teaspoonful represents two grains. The bisulphate 
may be given in solution in distilled water, fol¬ 
lowed by a teaspoonful of orange juice. In older 
children—those from two to six years of age require 
from 15 to 30 grains daily to control the disease— 
it is given in yerba santa, unless the child can be 
taught to take a capsule. Then 3-grain doses may be 
given every two hours until the child has taken the 
required amount. The practice of adults in giving 
a large dose of quinine a few hours preceding the 
expected chill, does not answer well in children, 
because such large doses may cause vomiting. 

When it is difficult to administer quinine by 
mouth, or it cannot be given in large enough doses 
without causing stomach trouble, it may be given 
intravenously by preparations on the market spe¬ 
cially prepared for that purpose. The use of quinine 
should not be stopped in malaria with the fever. 

It should be given for a week or ten days after the 
temperature fails to rise, unless there is a sub¬ 
normal temperature; then it is reduced to one-half 
the amount, or temporarily discontinued for a few 
days. It is difficult to tell when a case of malaria 
is cured. Oftentimes we think a patient is perfect¬ 
ly well, and weeks after he will develop another 
attack. Whether it is a new infection, or remains 
of the old infection, is difficult to say. Author¬ 
ities believe it is the old infection that remained 


Page Three Hundred Seventy-two 




TRAINING OF INFANTS AND CHILDREN 


inactive in the spleen, and in order to prevent this 
recurrence, the quinine should be given for a 
week of each month for at least a year following 
the original attack. The continual administration 
of the quinine will generally prevent the attacks 
and effect a cure. 

Paragraph 934 

IMPETIGO. 

Impetigo is a skin disease very common in 
children, and it is characterized by large, yellow 
scabs under which pus is secreted. It is very con¬ 
tagious and spreads rapidly over the face, hands or 
any part of the body that may become infected, and 
unless it is successfully treated it will cover the 
entire face. We have seen cases so completely cov¬ 
ering the face that a pencil point could not be 
placed upon normal tissue. 

The treatment consists of cleansing the scabs 
off with peroxide of hydrogen, and when there is not 
too much surface involved sponge the parts off good 
with fifty per cent alcohol and dry them quickly. 
The alcohol will be very painful for a minute or two. 
After this apply a powder or ointment containing 
calomel 20 grains, bismuth sub-nitrate 1 dram,, oxide 
of zinc 2 drams, white vaseline 1 ounce. This 
should be applied freely after the yellow scabs 
have been removed. 

This line of treatment should be commenced as 
soon as the first sore develops. This will prevent 
its spreading to other parts of the face or hands. 

Children often get this disease from playing 
with dogs and cats, also from old pieces of rotten 
wood or from digging in the dirt.. It is a disease of 
filth, and care should be taken to prevents its 
spreading. 

Paragraph 935 

* HERNIA. 

Hernia occurs very frequently in children, 
and in several different forms. Inguinal hernia 
occurs more frequently in boys; it is rarely seen 
in girls. Whooping cough, colic and constipation 
are some of the causes of hernia, and occasionally 


Page Three Hundred Seventy-three 


LECTURES OF INTEREST TO WOMEN 


it is congenital; that is, children are born with 
the hernia. In a boy, it often extends down into the 
scrotum, and the tumor becomes quite large. 

If an inguinal hernia occurs, and does not go 
back in place, it is reduced by laying the child on 
its back, with the legs and buttocks considerably 
elevated, and with the thumb and second finger 
grasping the lower portion of the tumor and exerting 
pressure gently upward and outward; this will often¬ 
times be successful. When this cannot be accom¬ 
plished a physician should be called, as he may have 
to give the child an anaesthetic before it can be 
reduced. The best treatment for an inguinal hernia 
is an operation. 

When a truss is used, it is generally unsatis¬ 
factory, and oftentimes it irritates the body at 
some point of contact sufficient to cause an 
abscess. If for any reason an operation cannot be 
performed, a truss should be properly fitted. To 
effect a cure, a truss must be worn at least two 
years. In some selected cases, a properly fitted 
truss will effect cure. 

Paragraph 936 

UMBILICAL HERNIA. An umbilical hernia may be 
either congenital or acquired. However, we believe 
the vast majority of cases are congenital, and it is 
due to the failure of the umbilical opening to close, 
which gives way under the pressure, such as strain¬ 
ing during whooping cough or in colic. 

The diameter may vary from one-fourth inch 
to one inch, and the hernia may protrude as far as 
one and one-half inches. It is very common, and 
usually makes its appearance during the early 
months of life. 

Paragraph 937 

TREATMENT. The treatment for umbilical hernia 
in infants is entirely mechanical. No operation is 
required in such cases. The most effective means is 
to bring together two folds of the skin over the 
umbilicus so that they may meet in a medium line; the 
two folds of the skin thus form a splint. Over this 
-s placed a strip of Z.O. adhesive plaster one or 


Page Three Hundred Seventy-four 






TRAINING OF INFANTS AND CHILDREN 


two inches wide; the length depending upon the size 
of the child. Strips are generally from four to six 
inches long. This method will prove to be the most 
satisfactory and effects more cures than any other. 
The habit of covering the opening with a button or 
any other form of a pad is not to be recommended, as 
it has a tendency to increase the opening. While it 
reduces the hernia, it prevents its rapid closure, 
and in place of making the parts stronger it makes 
them weaker. 

Any mother or nurse can apply the adhesive 
plaster as above suggested after being shown once 
by a physician. The child may be bathed with the 
plaster in position, and every four or five days it 
can be changed. Sometimes the skin becomes irri¬ 
tated. When this is the case the folds of the skin 
can be changed and plaster applied at different 
angles; by so doing, the part of the skin that is 
irritated remains uncovered, and if the treatment 
is applied as soon as it is discovered a cure can be 
expected in from three to six months; the younger 
the child the more rapid will be the cure. 

Paragraph 938 

VENTRAL HERNIA. This is a form of congenital 
hernia and we only see it in infants. It may occur 
with an umibilical hernia or it may be independent. 
The cause is possibly due to failure of the abdominal 
muscles to unite in the middle line or it may be due 
to a weakening of the muscular fibre. There is never 
any protrusion of the abdominal contents as we find 
in other forms of hernia. 

In Ventral hernia we generally have a full¬ 
ness or a distinct localized elevation of the skin 
over the site of the absent or weakened muscular 
tissue in the abdominal wall. 

TREATMENT. Treatment consists of the appli¬ 
cation of a four-inch strip of Z.O. adhesive plaster 
about one and one-half to two inches wide, placed 
flat on the skin over the hernia. This treatment 
will have to be continued for several months. It is 
possible that such cases might require an operation 
but the adhesive plaster will generally effect a 
cure. 

Page Three Hundred Seventy-five 





LECTURES OF INTEREST TO WOMEN 


Paragraph 939 

CONSTIPATION. 

Constipation in both infants and children is 
quite common, and is often more or less chronic. In 
young infants, the bowels should have at least one 
or two evacuations daily. Some only have one move¬ 
ment a day, yet seem to be perfectly well. As chil¬ 
dren grow older, and take more solid food, they 
suffer more as a rule with constipation than younger 
infants. Some children have three or four bowel 
movements a day, and yet they enjoy perfect health, 
and children who have only one movement a day are 
also perfectly well. These facts must be remembered 
when we consider constipation in children. 

Muscular development and the peristaltic 
action of the intestines in infants and children are 
not as well developed as in the adult, and this is 
one of the causes why children are prone to consti¬ 
pation. We find constipation more frequently in 
infants who are artificially fed than we do in the 
breast fed, which is possibly due to insufficient 
amount of sugar and fat in the food, or the child 
does not get a sufficient amount of water. 

When infants have stomach trouble, or when 
they have rickets, there is a lack of proper diges¬ 
tion, and a scanty amount of secretion in the in¬ 
testinal tract, and less peristaltic action. These 
all result in constipation. You must also remember 
that boiled milk or sterilized milk will cause con¬ 
stipation. 

Children who suffer with constipation have ,a 
loss of appetite and do not sleep well. Older chil¬ 
dren complain of headaches and pains in the stomach, 
associated with more or less gas in the bowels. 

When a case of constipation is suspected, there are 
several conditions, especially among children, 
that should be ascertained, and it. would be well to 
consult a physician and be sure if it is a real case 
of constipation, or if there is some form of in¬ 
testinal obstruction present. After it is a posi¬ 
tive fact that we. have a case of constipation to deal 
with, the treatment consists along the following 
lines. 


Page Three Hundred Seventy-six 





TRAINING OF INFANTS AND CHILDREN 


Paragraph 940 

TREATMENT. In treating a case of constipation 
it must be remembered that no two cases can be . 
treated exactly alike. What would secure one good 
bowel movement a day for one, would cause three or 
four movements in another case. The child’s physical 
condition and general habits of living must all be 
taken into consideration when treating constipation 
in children. What should govern the treatment would 
be the frequency and character of the bowel move¬ 
ments . 

■ At first, ascertain if the food is at fault, 
and if so, it should be corrected. For the imme¬ 
diate relief of constipation in infants, an injec¬ 
tion of half a pint of Castile soap water is very 
effective, also the glycerine suppository or soap 
suppository may be used. When a case of constipation 
persists, there should be a regular time for the 
bowels-to move, and a soap water injection should be 
given at that time, and should be continued for some 
time. No harm will result if the soapsuds enema is 
continued for several months. 

In cases where the stools are very hard and 
dry, an injection of an ounce or two of warm sweet 
oil, and have it retained in the rectum over night, 
will often soften the hardened mass, and give better 
results the next morning when the soapsuds enema is 
given. Some cases require a higher colon irrigation 
in order to get a complete evacuation of the bowels. 
In that case, the soft rubber catheter must be in¬ 
serted into the colon for several inches (four to 
six), and allow about six or eight ounces of warm 
water to enter the colon, in which has been dissolved 
a half a teaspoonful of inspissated ox-gall. The 
use of ox-gall is recommended only in cases which 
require a rapid and complete evacuation of the colon 
and rectum. Ox-gall is irritating and cannot be 
used continually, or too frequently in children. 

Paragraph 941 

DRUGS FOR CONSTIPATION. Mothers, as well as 
nurses, should realize the fact that it is not wise 
to try to cure a case of constipation with drugs 
alone. It is very unsatisfactory to continue the 


Page Three Hundred Seventy-seven 



LECTURES OF INTEREST TO WOMEN 


taking of cathartics each night, as is often prac- J 
ticed in adults, and the same is true of children. 
Drugs should be only one part of the treatment. 

For older children, who can swallow a pill, 
the anticonstipation pill (Waugh), made by the A.A. 
Co., is a very convenient and effective way to ad¬ 
minister drugs. It is an excellent formula, and for 
older children it can be increased or decreased as 
required. In combination with other treatment, a 
sufficient number of pills should be given—say, 
one to three—to a child 12 or 14 years old, two or 
three times a day after meals (the best time would 
be the noon and evening meal), to produce one daily 
stool, and reduce the dose as results are secured. 

Maltine with cascara is good. A teaspoonful 
given to older children once during the day, espe¬ 
cially in the morning. Where children are fed large 
quantities of starchy foods, give calcined magnesia. 
For rickety children one-half to one teaspoonful of 
olive oil or cod liver oil may be ordered three or 
four times a day. Liquid Albolene (mineral oil), 1 
or 2 teaspoonfuls two or three times a day is also 
recommended. In giving mineral oil, it is best given 
on a half a wine glass of real cold water, using the 
plain unflavored oil. This oil has no medicinal 
properties, and does not act as a cathartic, simply 
acts as a lubricant to the alimentary canal, and can 
be given indefinitely. For very young infants, a 
half teaspoonful of malt extract may be added to 
each feeding. One teaspoonful of Loefflund’s malt 
soup may be added to the feeding, the same as the 
malt extract, and the dose may be increased or dimin¬ 
ished as the case requires. 


Paragraph 942 

DIET FOR CONSTIPATION. In feeding infants and 
children suffering with constipation, a great deal 
of care and attention must be given to the diet, and 
at the same time adding different correctives to 
the food is important; thus Phillips’ Milk of Mag¬ 
nesia, 34 to 1 teaspoonful given in the morning feed¬ 
ing, or it may require even more than that to obtain 
the desired results. 


Page Three Hundred Seventy-eight 






TRAINING OF INFANTS AND CHILDREN 


The method of heating the food, the milk 
supply, and the quantity of water given to infants, 
must be considered when treating a case of constipa¬ 
tion. Instead of using plain water to dilute the 
milk, sometimes adding oatmeal water will help con¬ 
stipation. The milk may also be diluted with a 5 per 
cent solution of sugar of milk, which is an excellent 
corrective. Infants over a year old, suffering with 
constipation, should be given a small amount of 
oatmeal porridge containing a teaspoonful of butter 
or a teaspoonful of sugar of milk. 

All starchy foods have a tendency to cause 
constipation, while fruits, like apple sauce, 
oranges and grapes, have a laxative effect. Prunes 
and Senna leaves stewed to a jelly in sugar and 
water are also valuable. In older children butter¬ 
milk is given. Very acid fruits should not be al¬ 
lowed. Care should be taken not to disturb a child’s 
digestion by using the foods just mentioned in too 
large amounts, or giving them too frequently, or too 
many at a time. It is best to try one article and 
then another, and use the one most satisfactory in 
any given case. What agrees with one will not affect 
another. Rely largely on the diet, giving as small 
amount of drugs as possible. Louis Starr gives the 
following constipation diet list: 


Paragraph 943 

First Meal, 7 A.M.—A breakfastcupful of new 
milk, with an additional tablespoonful of cream; 2 
to 4 tablespoonfuls of thoroughly cooked oatmeal or 
cracked wheat porridge, with cream and salt; 2 
slices of whole wheat or bran bread, buttered; the 
juice of a ripe orange, or half of a moderate sized 
ripe apple scraped with a spoon, or a small ripe 
pear, scraped, or a peach. 

Second Meal, 11 A.M.—A teacupful of milk, 
with an additional tablespoonful of cream; a slice 
of bran bread. 

Third Meal, 2 P.M.—A breakfastcupful of 
mutton or chicken broth, or 1 or 2 -tablespoonfuls of 
underdone roast mutton, beef, or chicken minced 


Page Three Hundred Seventy-nine 





LECTURES OF INTEREST TO WOMEN 


fine and pounded to a paste; puree of spinach; 
mashed cauliflower tops; asparagus tips; stewed 
celery; whole wheat or bran bread, buttered; junket 
and cream; rice and milk pudding with stewed prune 
juice; baked apple with cream. 

Fourth Meal, 6:30 P.M.—Milk, 1 or 2 break- 
fastcupfuls, with additional cream; whole wheat or 
bran bread, buttered, stewed fruit. 

Older children are not fed so frequently, but 
they should be given regularly a glass of water, 
either hot or cold, an hour before breakfast. Add 
cream and water to their milk. Barley or oatmeal 
water may also be added to the milk. That is, to a 
glass of whole milk, add % ounce of cream and 2 or 
3 ounces of barley water or oatmeal water. Meat 
broths are also laxative, and plenty of ripe fresh 
fruits, when taken before meals, are very service¬ 
able. Figs and prunes stewed together are very help¬ 
ful. Oatmeal or brown bread of any kind is better 
than white bread, and as a child grows older, the 
management will be similar to that for adults. 


Paragraph 944 

Briefly, Holt says: ‘‘To treat a chronic case 
of constipation in a child four years of age, mas¬ 
sage for eight minutes, night and morning; give the 
juice of half an orange and a glass of Yichy imme¬ 
diately upon rising; a breakfast of oatmeal, with 
one ounce of cream, dried bread with butter, an egg, 
a half glass of milk with cream and water added; a 
dinner of soup, one starchy vegetable, that is, 
potato with cream, and one green vegetable, beef¬ 
steak, baked apple or prunes, dried bread and 
butter, and water to drink; for supper, cream 
toast, egg, dried bread and butter or Graham 
crackers, half a glass of milk with cream and water 
added.’’ 


Paragraph 945 

EXERCISE. Exercise for older children is very 
important. A child should have plenty of outdoor 
play and exercise. Let it romp and play to the point 
of fatigue. For older children, bicycle riding and 


Page Three Hundred Eighty 




TRAINING OF INFANTS AND CHILDREN 


horseback riding are to be recommended, but the 
exercise must not be carried too far, as over-indul¬ 
gence in such exercise will frequently have very 
serious after effects. Limtiing the amount of such 
play and exercise to an hour, once or twice a day, 
would seem to be sufficient. 

In young children, who cannot take such exer¬ 
cise, massaging the abdomen will have a tendency to 
assist in the treatment of constipation. Rubbing 
the abdomen with the aid of any lubricant, like 
vaseline or olive oil, will be found serviceable. 

In older children, the use of the vibrator over the 
abdomen for a few minutes (say 10 minutes) will 
assist in stimulating the peristaltic action and 
tone up the muscles. This can be continued for a 
month at a time. 

To massage the abdomen, the hands are gently 
placed on the lower right hand side of the abdomen, 
and gentle pressure should be made. Do not use suf¬ 
ficient force to cause the abdominal muscles to be¬ 
come tense. Commence each pressure gently, gradual¬ 
ly becoming firmer; then after a firm pressure, apply 
a sort of a rotary movement. Continue this pressure 
or rotary motion method of massage up the right side 
of the abdomen, across to the left side and down to 
the right side. This massage may be continued morn¬ 
ing and evening for ten minutes, for several weeks. 
When any improvement is noticed, then give the 
treatment less frequently. It may require several 
months to obtain satisfactory results. 

As mentioned, there is a lack of muscular tone 
and peristaltic action in children, and the mas¬ 
sage assists in stimulating this condition. Do not 
be disappointed if immediate results are not se¬ 
cured. In a case of chronic constipation, it re¬ 
quires six or eight months treatment before satis¬ 
factory results are secured. This is true in ob¬ 
stinate cases. To sum up the treatment of chronic 
constipation in a child four years of age, Holt says: 
‘‘Massage the abdomen as mentioned above, eight 
minutes night and morning.*’ 


Page Three Hundred Eighty-one 


LECTURES OF INTEREST TO WOMEN 


Paragraph 946 
CIRCUMCISION. 

In most all cases the foreskin in the male 
infant is too long, or the opening is so small that 
it cannot be slipped back and forth over the gland. 
This condition, if left alone, causes extreme nerv¬ 
ousness, bed wetting, and bad habits. In a very 
small percentage of cases the opening in the fore¬ 
skin is of a fair size, and when it is properly 
stretched, and the adhesions broken up, and followed 
up with the necessary after care, circumcision may 
not be necessary. The after care consists of apply¬ 
ing a 10 per cent boracic acid ointment to the parts 
night and morning, and slipping the foreskin back 
and forth over the gland at least twice a day, for a 
week or ten days. 

In cases where the opening is small, or when 
the foreskin is too long, complete circumcision is 
absolutely necessary. This operation should be per¬ 
formed on the sixth or seventh day. No anaesthetic 
is required, and if done by a physician no harm ever 
results. The harm is done by allowing this con¬ 
stricted condition to remain; therefore, every 
parent should not hesitate to recommend, in fact 
demand, circumcision at the proper time, and save 
any future trouble. 

The advantage of having circumcision per¬ 
formed during the puerperium is that the nurse can 
look after the case while the mother is in the hos¬ 
pital, and the attending physician can be consulted 
when necessary. If circumcision is not performed at 
the proper time, but left until later in life, it 
will require an anaesthetic, with additional cost 
and risk to the child. 


Paragraph 947 
MASTURBATION. 

This is not an uncommon habit of childhood, 
and it occurs in both male and female—more often in 
the male. The cause of masturbation may originate 
from any irritation applied to the genital tract; 
such as acid urine, which causes excoriation of the 
skin, or when the diaper is pinned too tight; and in 


Page Three Hundred Eighty-two 






TRAINING OF INFANTS AND CHILDREN 


the case of boys, where there is irritation caused 
by an elongated and contracted foreskin. Also the 
accumulation of smegma around and about the clitoris 
may be the cause of masturbation. Frequently pin 
worms may wander into the vagina, and from there set 
up local irritation of the parts, resulting in mas¬ 
turbation. 

Children who acquire the habit of masturba¬ 
tion may do so by rubbing the thighs together, or by 
placing their hands on the genitals. They often 
continue this practice until they become exhausted, 
and their face becomes flushed. Such children 
suffer from marked anaemia, loss of sleep, are 
irritable, peevish, and very sensitive. If con¬ 
tinued, it affects their mentality, and in time 
destroys their mental functions, and the child be¬ 
comes an imbecile, both mentally and physically; 
therefore, it is very necessary that mothers detect 
this habit, and see that the cause is removed at 
once. The results are generally good if taken in 
time and properly treated, yet some cases are very 
persistent in spite of everything that can be done, 
and require most heroic measures to effect a cure. 

Paragraph 948 

TREATMENT. The cause must be removed, and 
all irritation of the genitals treated. Boys should 
be circumcised, and see that there is no eczema or 
worms irritating the parts, and all vaginal dis¬ 
charges must be cured. Older children should be re¬ 
moved from bad company, and oftentimes it may be 
necessary to change the entire surroundings, in 
order that any treatment will be effective. The best 
hygienic surroundings should be established. Plenty 
of fresh air, clean habits, and daily baths are 
necessary. Ocean voyages are to be recommended,, 
and the proper care, with the aid of a trained nurse, 
will often do as much, if not more, in such cases as 
medicine. When children once acquire this habit, 
they should never be allowed to sleep with their 
hands under cover. Circumcision should be performed 
when required, and is valuable in effecting a cure 
in boys. In girls, especially little girls, often 
breaking up the adhesions about the clitoris and 


Page Three Hundred Eighty-three 





LECTURES OF INTEREST TO WOMEN 


cleansing the parts will modify, if not cure, the 
habit. In girls, when this does not effect a cure, 
then a radical operation of removing the clitoris 
is to be recommended, and may be required. 


Paragraph 949 

LEUCORRHEA IN CHILDREN. 

In young girls, even in infancy, there quite 
often occurs a profuse leucorrhea discharge. The 
mother or nurse who knows this fact may be saved a 
great deal of unnecessary anxiety. It is generally 
an evidence of low vitality. Sometimes it is caused 
by pin-worms that find their way into the passage 
from the bowels. Sometimes the infection is 
specific, gonorrhea in origin. It is a serious mat¬ 
ter and decidedly contagious. A child may take the 
infection from towels that have been used by a 
person who has gonorrhea. 

Paragraph 950 

TREATMENT. In the former condition, when it 
is simply a case of leucorrhea, the treatment con¬ 
sists of great cleanliness; washing the parts with 
boracic acid solution, and using a soft rubber 
catheter and funnel to give a vaginal douche with. 
A non-irritant antiseptic like Chlorazine, in 
strength 1-10,000, may be used.. If the external 
parts become irritated, oxide of zinc ointment 
should be applied, and a piece of lint, or fold of 
gauze should be laid between the labia, in order to 
keep them separated, and allay the inflammation. 
When a case does not respond to treatment as out¬ 
lined, you had better consult your physician. 

Paragraph 951 

ERYSIPELAS. 

Erysipelas is a*common infectious disease 
affecting infants, children and adults. It is usu¬ 
ally fatal in about fifty per cent of the cases in 
children under one year of age. The reason that it 
is fatal in young children is because of the inter¬ 
ference with nutrition, long continued high tem¬ 
perature, discomfort from the inflammation, and 
loss of proper rest. The action of the toxaemia in 


Page Three Hundred Eighty-four 


TRAINING OF INFANTS AND CHILDREN 


the system causes such a low vitality that if it 
does survive the acute stage, it is very apt to die 
later from exhaustion. 

Erysipelas is characterized by a reddened, 
slightly swollen condition of the skin, which has a 
distinct line of demarcation; that is, the inflam¬ 
matory condition extends over new tissue, and you 
can see plainly how far the infection has extended 
by a distinct line where the inflammatory condition 
and normal tissue meet. It may start on any part 
of the body, but it is generally on the face and often 
extends over the forehead and scalp, extending 
down the back and around the neck. The skin has a 
very distinct inflammatory appearance. 


Paragraph 952 

NURSING TREATMENT. Nursing treatment, and 
the treatment in general, in young children is very 
uncertain, and for that reason the younger the 
child, the graver the prognosis. There is but lit¬ 
tle hope of recovery in such cases, and the favor¬ 
able termination of the case depends upon the ex¬ 
tent of the resistance of the patient and the se¬ 
verity of the infection. 

One of the most important features in the 
treatment is to give the patient plenty of fresh 
air. The windows should be wide open continually. 
Keep the child warm with clothing and hot water 
bottles. Mother and nurse should bear in mind that 
children suffering with erysipelas are liable to 
have more or less stomach and bowel trouble; espe¬ 
cially is this true of bottle fed babies. In such 
cases, the food should be reduced fifty to sev¬ 
enty-five per cent by the addition of barley water. 
This will riot increase the amount of liquid taken, 
but would reduce the amount of food. 

During the entire attack, and throughout 
convalescence, the child shoqld be fed only to the 
limit of its digestive capacity--never beyond it. 
Mothers and nurses should make frequent inspection 
of the stools in order to determine the condition 
of the stomach and bowels. 

Page Three Hundred Eighty-five 


LECTURES OF INTEREST TO WOMEN 


The local applications used in erysipelas 
are various strengths of Ichthyol, from five to 
thirty per cent. Another preparation which is of¬ 
ten used is a saturated solution of Potassium 
Permanganate. 

Sometimes in infants the inflammation ex¬ 
tends over a large area, and in that case, care must 
be taken not to cover too large a surface of a small 
child, as it interferes with the functions of the 
skin, and may become a serious matter. As the dis¬ 
ease advances, the lotions are applied and followed 
up the extension of the inflammation. 


Paragraph 953 
EPILEPSY. 

In considering this disease, which is not 
very common among children,the symptoms and 
conditions that are present during the attacks are 
sufficiently known, and they need not be repeated 
in connection with this article. 

Paragraph 954 

NURSING TREATMENT: A case of epilepsy should 
be placed under the best hygienic surroundings that 
is permitted by the patient’s station in life. They 
should have plenty of outdoor life. Sports and 
games are enjoyed, but not to the point of fatigue; 
always keep within the line.s of moderation. The 
child should sleep in a cool well ventilated room 
at all seasons of the year. If attending school, 
the child should receive instruction at home, and 
the sessions at school made short and studies easy; 
mental fatigue should be guarded against. 

The social part of a child’s life should be 
managed with a great deal of care. Theater going 
and exciting amusements are forbidden, especially 
if the plays are of an emotional and exciting nature. 

A diet suitable for the child’s age should be 
given, consisting of the most nutritious and easily 
digested foods, just the same as for a normal child. 
Meat should be given only once a day. Careful at¬ 
tention to the diet and bowels are the most import¬ 
ant features in the nursing treatment. An epileptic 


Page Three Hundred Eighty-six 



TRAINING OF INFANTS AND CHILDREN 


patient should not pass over twenty-four hours 
without an evacuation of the bowels. Mothers and 
nurses will add greatly to the child’s comfort if 
a copious enema is given quite often-every second 
or third day at least. If there is any tendency 
towards constipation, the same treatment should 
be employed as recommended in chronic constipation. 

The importance of a correct diet, care of the 
bowels, habits, and hygienic surroundings cannot 
be over-estimated in assisting to diminish the 
frequency and severity of the attacks. To those 
who are unable to give the patient suitable atten¬ 
tion and care at home, we recommend that they 
place the patient in some institution devoted ex¬ 
clusively to the care of epileptics. 

If any of the readers of ‘‘Lectures of Inter¬ 
est to Women’’ should be so unfortunate as to have 
an epileptic in their family, we will be only too 
glad to send them our advice and knowledge in re¬ 
gard to medical treatment if they will enclose a 
stamped self-addressed envelope. We believe that 
our suggestions along this line would be worth the 
asking. 


Paragraph 955 

INFANTILE PARALYSIS. 

Infantile paralysis is a disease that affects 
the spinal cord. It is highly contagious and has 
occurred quite frequently throughout this country 
and increased with great rapidity within the last 
ten years. Children that recover from an attack are 
invariably left hopeless paralytics and deformed, 
oftentimes rendered helpless, and a constant care 
upon their parents. 

All children are affected alike, the healthy 
as well as the sickly. It is essentially a disease 
of childhood. The symptoms of infantile paralysis 
show themselves without any warning. It may be a 
single case and the only one in the community. The 
child will suddenly complain of headache, fever, 
nausea and vomiting. There is often a rigidity of 
the muscles of the neck and spine, and pains radi¬ 
ating in the arms and legs. Paralysis occurs any 


Page Three Hundred Eighty-seven 







LECTURES OF INTEREST TO WOMEN 


time within six days after the attack begins, and 
involves the legs and upper part of the body. In 
some cases the paralysis clears up after recovery. 

As a rule though, it leaves its after effects, as 
mentioned above. The paralysis is a result of the 
poison affecting the brain, spinal cord and nerves 
of the muscles. When the child is exposed to in¬ 
fantile paralysis, and it becomes infected, it will 
show symptoms of the disease any time between the 
second and tenth day. 


Paragraph 956 

NURSING TREATMENT: During the acute stage 
the child should be kept quiet in bed, and bowels 
should be kept regular. Light, easily digested 
nourishment should be given and the patient made 
generally comfortable. The child should be kept 
away from other children or members of the family. 
When contagious hospitals are accessible, the case 
should be sent to the hospital, in order to prevent 
other members of the family from becoming infected. 
It is extremely contagious; therefore, mother, 
nurse and physician should realize this fact and 
take every precaution not to spread the infection. 

All the discharges from the patient must be 
thoroughly disinfected with some good antiseptic. 
Chloride of lime solution (one-half pound to two 
gallons of water) is a good solution to use. All the 
bed linen, clothing, and dishes must be dipped into 
this solution before being removed from the room 
It is a good precaution to hang sheets dipped in the 
bichloride solution (1-2000) over the door. 

The don’ts are important and should be faith¬ 
fully executed by the mother, nurse and physician. 
Don’t allow family pets to remain in the house. 
Don’t allow anyone in the sick room but the physi¬ 
cian, nurse or attendant. Don’t allow any insects 
to remain alive in the room. 

There is no disease in childhood in which so 
little hope is to be held out for the patient. 
Sometimes they recover and are left invalids the 
rest of their lives. The mortality varies from 
sixty to ninety per cent. 


Page Three Hundred Eighty-eight 


TRAINING OF INFANTS AND CHILDREN 


Paragraph 957 

EMOTIONAL INSANITY. 

This subject means so much, in relation to 
parents and children, that it is impossible to give 
it justice in ‘‘Lectures of Interest to Women,’’ on 
account of space, but let us briefly note the results 
that come from emotional insanity. Many, many times 
it is the cause of a nervous breakdown, which ends 
in a ruined life. 

We have said that infants are little creatures 
of habit, wonderful imitators, and sensitive of 
their surroundings. The mother feeds her baby im¬ 
properly; gives it too much food or not enough; lets 
it nurse too long; gives it a pacifier; lets it suck 
its thumb; anything to give her a little immediate 
peace, and not disturb the neighbors in the flat 
above. Such small beginnings are the start of seri¬ 
ous conditions that develop later in the way of 
digestive disorders, nervousness, hysterical vom¬ 
iting, biting the fingernails, etc., and such con¬ 
ditions may start the little one on the road to 
serious nervous and mental disturbances, the real 
origin of which is not recognized by the parent. 

In a fit of emotional insanity, the father 
punishes the child beyond reason, and it is often 
transmitted to the child in a way that will have its 
lasting effect. We often see emotional insanity 
developed in a small child, and it becomes vicious, 
takes things from brother or sister, tells little 
lies, tries to slap the parents, gets in the habit 
of running away, seemingly to free himself of un¬ 
pleasant surroundings. Let a child be over-pun¬ 
ished, and if it is naturally of a sensitive dis¬ 
position, it may be the beginning of its downfall. 
This nervous condition and vicious disposition may 
be the cause of leading it to acts of all sorts of 
immorality, or the child may land in the insane 
asylum. Take the history of all criminals and mur¬ 
derers, and analyze their history, going back to 
their childhood, and see for yourself the emotional 
insanity that surrounded their lives during child¬ 
hood. 

Mark you, the child itself tends to give back 
just what it gets. We see emotional insanity in 


Page Three Hundred Eighty-nine 



LECTURES OF INTEREST TO WOMEN 


children where the parents show no love for each 
other, and the child never sees any real affection 
between them, but it does see and hear the mother 
say harsh words, slam the door and leave the room, 
after having had words with the father, while she is 
in a fit of emotional insanity. These burdens the 
child must bear, and it means only a nervous and 
mental breakdown in the end. Parents should realize 
this; note their liability to emotional insanity 
and control it, and not allow it to be imparted into 
the life of the boy and girl whom they have brought 
into this world. If they do not realize this fact, 
the end of the chapter in the ‘ ‘Book of Life’ ’ may be 
the development of a nervous breakdown, so serious, 
perhaps, as to result in criminals or insanity. 

Paragraph 958 

ELECTRIC SHOCK. 

In treating an electric shock, the first thing 
to do is to call a physician. Accidental electric 
shock does not usually kill a patient at once; only 
stuns him and stops the breathing. The hope of 
saving the victim lies in the prompt and continued 
use of artificial respiration. 

See that there are no foreign bodies in the 
mouth. If there are any, quickly remove them with 
the fingers. Do not stop to loosen the patient’s 
clothing, as every moment of delay is serious. Lay 
the patient on his stomach, with arms extended as 
straight forward as possible, with face on one side, 
so that the nose and mouth are free for breathing. 
Draw out the patient’s tongue, which is best done by 
an assistant. If there are any burnt places, lay 
the patient, if possible, so that none of them are 
pressed upon. 

Now straddle the patient’s thighs, facing his 
head; put the palms of your hands on the muscles of 
the small of the back, with thumbs nearly touching 
each other, and fingers spread over the lowest ribs. 
With the arms held straight, swing forward slowly, 
so that the weight of your body is gradually brought 
to bear on the patient. This must not be violent, 
but should take from two to three seconds. The lower 


Page Three Hundred Ninety 




TRAINING OF INFANTS AND CHILDREN 


part of the chest and also the abdomen are com¬ 
pressed, and the air is forced out of the lungs. 

Now immediately swing backward so as to re¬ 
move the pressure, but leave your hands in place, 
thus returning to normal position. The chest walls 
expand, and the lungs are thus supplied with fresh 
air. After.two seconds swing forward again. Thus 
repeat twelve to fifteen times a minute, the double 
movement of compression and release—a complete 
respiration in four or five seconds. Follow the 
natural rate of your own breathing, swinging for¬ 
ward with each expiration, and backward with each 
inspiration. While this is being done, an assistant 
should loosen any tight clothing about the patient’s 
neck, chest or waist. 

In serious cases, continue artificial res¬ 
piration without interruption for two hours or 
longer, until natural breathing is restored, or 
until the physician arrives. After natural breath¬ 
ing begins, carefully watch that it continues. If it 
stops, start artificial respiration again. During 
the period of operation, keep the patient warm by 
applying a proper covering, and by laying beside the 
body rubber bags filled with warm water. To keep 
the patient warm should be the duty of the assistant. 
Do not give any liquids whatever by mouth until the 
patient is fully conscious. 

When normal respiration has been restored, 
the burns, if serious, should be attended to until 
the doctor comes. A raw or blistered surface should 
be protected from the air. If clothing sticks to 
the skin, do not peel it off, but cut around it. The 
adherent cloth, or a dressing of common soft 
material, is applied to the burned surface, satur¬ 
ated with picric acid (0.5 per cent). If this can¬ 
not be obtained, use a solution of baking soda 
(1 teaspoonful to a pint of water) , or the wound may 
be coated with a paste of flour and water. Unguen- 
tine may also be used, or it may be protected with a 
plain vaseline. Cover the burn with gauze, clean 
waste, clean handkerchief or other soft cloth, held 
tightly in place by a bandage. The same covering 
should be lightly bandaged over a dry burn, but 


Page Three Hundred Ninety-one 


LECTURES OF INTEREST TO WOMEN 


without wetting or applying oil to it. Do not open 
blisters. 

The victim must be separated from the live 
conductor quickly, but in doing so, you must avoid 
receiving a shock yourself. Many persons have re¬ 
ceived vital injury by trying to disconnect victims 
of shock from live conductors. One should observe 
the following directions: If a child, or any member 
of the family, should be connected with a live con¬ 
ductor, use a dry coat, a dry rope, a dry stick or 
board, or any other dry non-conductor, to move 
either the victim or the wire, so as to break the 
electric contact. Never use metal or any moist 
material. The victim’s loose clothing, if dry, 
may be used to pull him away. Be careful and do not 
touch the heels of his shoes while he remains in 
contact with the wire, on account of the nails. If 
the patient’s body must be touched by your hands, 
the hands should be covered with rubber gloves, or 
stand on a dry board or some other dry insulating 
surface. If possible, use only one hand. 

If the patient is lying on the ground, clutch¬ 
ing the wire, either shut off the current, lift him 
off the ground, or cut the wire. This releases his 
grasp. Opening the nearest switch is the quickest 
way to break the current. To lift.the patient off 
the ground is often difficult. 

If an accident should occur about the house, 
with children, immediately open all the switches. 
If necessary to cut a live wire, use an axe or 
hatchet with dry wooden handle. 

Great care should be taken to observe the 
above suggestions, and the patient should be re¬ 
moved from the live conductor, and artificial res¬ 
piration should be employed as recommended, regard¬ 
less of the fact that the victim appears dead. Re¬ 
member the importance of immediate and faithful 
application of artificial respiration in order to 
save the patient suffering from electric shock. 

Paragraph 959 
GAS ASPHYXIA. 

Every mother and nurse should be thoroughly 
familiar with the method of treating such cases. It 


Page Three Hundred Nipety-two 




TRAINING OF INFANTS AND CHILDREN 


is a condition that often occurs, as gas occasion¬ 
ally escapes from leaks in the pipes, when the gas 
is not turned off properly, or it may be used with 
suicidal intent. 

To treat a person suffering from illuminating 
gas, would require effervescent phosphate of soda, 
aromatic spirits of ammonia, one bottle ordinary 
ammonia, drinking vessel of some kind, a pair of 
tongue forceps, a small wooden mouth gag, and a 
towel. 

Patients are affected to various degrees, 
some only slightly, others unconscious but still 
breathing, and those that are apparently dead and 
not breathing. 

Paragraph 960 

TREATMENT: The patient should be moved to 
where he will get fresh air, loosen the clothing 
and, if he is able, keep him walking'around. If he 
can swallow give him a dose of effervescent phos¬ 
phate of soda in a glass of water; follow this in 
five or ten minutes with one-half a teaspoonful of 
aromatic spirits of ammonia in two-thirds of a glass 
of water. Give the spirits of ammonia every fifteen 
minutes for four doses. Keep the patient awake and 
walking around. 

When the patient is unconscious, or partly 
unconscious, place him in the fresh air, loosen the 
clothing and put a roll under the shoulders and 
neck. Have the roll made out of an old coat or 
blanket, and it should be large enough to cause the 
head to fall backwards. Rub the arms and legs toward 
the body. If he is able to swallow give the patient 
one-half teaspoonful of aromatic spirits of ammonia 
every fifteen minutes for four doses. 

When the patient is unconscious, open jaw and 
insert a mouth gag or block of wood, or anything to 
keep the teeth apart. Grasp the tongue with tongue 
forceps and remove all mucous from the mouth. Take 
the stronger ammonia, and it is good to have a sponge 
in the bottle in place of the cork, and pass it under 
the patient’s nose about once a minute as the 
patient breathes in. 

Page Three Hundred Ninety-three 



LECTURES OF INTEREST TO WOMEN 


Perform artificial respiration by pressing 
on the ribs every time the breath goes out. Continue 
this treatment until the patient is conscious and 
able to breathe for himself. After he is conscious 
give the patient one-half a teaspoonful of aromatic 
spirits of ammonia in one-third of a glass of water. 

Keep the patient perfectly warm with hot 
water bottles and plenty of clothing. Place his 
head upon a pillow and remove the roll from under 
the shoulders. 

If the patient is not breathing or unconsci¬ 
ous, you will rub the limbs toward the body. Open 
the mouth, insert the mouth gag and grasp the tongue 
with the tongue forceps and pull it forward, or 
grasp the tongue between the thumb and fingers, 
covering them first with a towel. Clear the mouth 
and place the patient on his back with the head turned 
to one side. Pass the ammonia bottle under the 
patient’s nose' once a minute and employ artificial 
respiration. Kneel across the patient’s back and 
place your hand over his ribs in such a way that the 
thumbs will extend about six inches below the arm 
pits. Then swing your body forward so as to allow 
your weight to fall vertically upon your wrists. In 
this way compress the chest wall, then swing forward 
in an upright position, releasing this pressure. 
Repeat this about twelve times a minute. Use no more 
force than is necessary to cause a deep expiration. 
This can be determined by the sound made by the air 
escaping from a patient’s nose and mouth. Care 
should be taken not to overdo or to be too violent in 
giving artificial respiration by this method. 

As soon as the patient begins to breathe and 
is able to continue, stop artificial respiration 
and place the patient on his back and press the sides 
every time he breathes out. This should be con¬ 
tinued until he is able to breathe naturally with¬ 
out assistance. 

After the patient has been revived surround 
him with hot water bottles, hot bricks or bottles 
filled with hot water—anything to keep him warm 
and keep the patient well covered with a coat, com¬ 
fort or anything at hand. 


Page Three Hundred Ninety-four 


TRAINING OF INFANTS AND CHILDREN 


In performing artificial respiration do not 
be discouraged if the patient shows no sign of 
breathing, continue the motions regularly at least 
an hour. While doing this secure such help and give 
such directions as needed to assist you, keep work¬ 
ing, do not tire, because faithful persistence in 
artificial respiration in such cases has saved many 
a life. 

When the patient is unconscious or not breath¬ 
ing it is advisable to send for a physician, but in 
the meantime devote every effort to reviving the 
patient by following out the above instructions. 

Paragraph 961 

DROWNING. 

Drowning is an accident for which every 
mother ought to be prepared to treat. There is no 
time to send for medical aid, so an effort must be 
made to revive the patient if there is the slightest 
chance of doing any good. As soon as the child is 
taken out of the water, all clothing should be 
loosened about the neck; lay the child with face 
downward for a second or two until the water runs 
out of the mouth. It should then be laid on its 
back, with the shoulders slightly raised, and a 
folded coat or garment of. some kind placed under 
them, with the head just touching the ground. Grasp 
the tongue with the thumb and index finger (covered 
with a handkerchief or cloth), have it drawn well 
out of the mouth, and keep in this position. 

Artificial respiration should be commenced 
at once; ‘‘Sylvester’s method,’’ is the one 
generally used, and it is performed by kneeling be¬ 
hind the unconscious child; seizing the arms and 
swinging them around horizontally, close to the 
ground until they meet above the head, pulling upon 
the arms quite strongly while they are in that posi¬ 
tion. This position is intended to expand the 
chest and make the air enter it. 

The arms should be in this position about 
two or three seconds, then they are brought to the 
sides of the chest, and given a forcible push 
against the lower ribs. This maneuver lasts only 


Page Three Hundred Ninety-five 


LECTURES OF INTEREST TO WOMEN 


about one second. The object is to expel the air 
from the lungs. The air should be forced in and 
out of the lungs 18 to 20 times per minute. The 
movement should be kept up for a long time; often as 
long as a couple of hours, until it is absolutely 
certain that there is no heart action; that it has 
ceased to beat. Do not let the pulse be a guide as 
to when to stop artificial respiration. 

While artificial respiration is being per¬ 
formed, someone should remove the wet clothing, dry 
the body, and apply warmth in any form--hot blank¬ 
ets, hot water bottles, hot stones, hot sand, or 
anything at hand. The limbs should be rubbed to¬ 
wards the body, in order to increase the circula¬ 
tion of the blood. 

When breathing begins, artificial respira¬ 
tion must be continued to keep time with the breath¬ 
ing, in order to give the patient all the help 
possible. 

Inhalation of smelling salts, ammonia or 
amyl nitrite, or slapping the face with wet cloths, 
will also aid respiration. The child should be 
given stimulants as soon as it can swallow. Do not 
move the child until it has fully recovered, unless 
the weather is such as to necessitate its being 
moved. Remember to keep the chiid warm. 

NOTE: Any mother who is not familiar with 
the movements of artificial respiration should re¬ 
ceive special instructions, and practice upon a 
living subject, until she is thoroughly familiar 
with the movements, and can make them to correspond 
with the living subject. 

The ‘‘lung-motor’’ is of great value in these 
cases and when an instrument can be secured, it 
should be used. Every mother or nurse should be 
instructed how to operate a lung-motor. 

Paragraph 962 

ST. VITUS’S DANCE OR CHOREA. 

St. Vitus’s dance is a nervous condition 
which is generally seen in children. There is an 
irregular jerky movement of the arms and legs. The 


Page Three Hundred Ninety-six 



TRAINING OF INFANTS AND CHILDREN 


disease often begins with the child dropping its 
food at the table; appears to be awkward in walk¬ 
ing and handling different articles; falls fre¬ 
quently and trips over things. The disease may be 
so severe that the child will be unable to feed or 
dress itself, and will not be able to walk or talk. 

The causes are anything that will produce an 
over-strain of the nervous system; such as, fright 
or overwork. It is often seen in children who are 
affected with rheumatism. Some authors state that 
the two diseases are so closely associated with 
each other that it is impossible to separate them, 
and many authors have agreed upon the fact that 
association between chorea and rheumatism is a 
most intimate one. About 80 per cent of all cases of 
St. Vitus’s dance can be associated with rheuma¬ 
tism directly or indirectly. If they have not had 
it themselves, possibly the parents have had it. 

The greatest danger is that the heart may be 
affected following the disease. 


Paragraph 963 

NURSING TREATMENT. The care and management 
of a child suffering with St. Vitus’s dance depends 
upon the degree and severity of the attack. In very 
bad cases, the child should remain in bed for three 
or four weeks; and in a very mild case, such a rest 
might do harm. 

The guide to go by is when the child cannot 
feed itself, and a rest in bed for a week or two is 
strongly advised. A mental rest is absolutely 
necessary, and oftentimes this can be obtained in 
bed better than any other way, but if mental excite¬ 
ment can be eliminated, and the child have an 
outdoor life and exercise, so much the better. 

One important point in the care of such a 
case, is for the mother and nurse to see that the 
child never becomes fatigued, either physically or 
mentally. 

When a child has been confined in bed for 
some time, it should return gradually to its regu¬ 
lar habits. Allow it to be up for only a half hour 


Page Three Hundred Ninety-seven 


LECTURES OF INTEREST TO WOMEN 


the first day, an hour the second day, and so on 
until it returns to its usual habits of living. 

Never allow a child suffering with St. 
Vitus’s dance to attend school; no matter how mild 
the attack. In some cases, in order for the child 
to have the needed rest, it is often necessary to 
remove the child from its home and place it among 
relatives, with a different environment. Cases 
that are so severe that they are often in bed, should 
be made to rest for two hours every day after dinner 
(which should be the noon meal). 

Paragraph 964 

The diet in such cases should be anti-rheu-, 
matic, and every case should be cared for and • 
treated the same as if it were a rheumatic patient. 
Great care should be taken in giving anti-rheumatic 
medicine, as this interferes with the appetite and 
digestion. It is best to treat a child for five 
days and then let it rest for the same length of 
time. The child must be treated for the nervous 
condition as well as the rheumatic condition, be¬ 
cause treating the rheumatism alone will not effect 
a cure. 

Paragraph 965 

Arsenic In some form is generally given in 
addition to the remedies for rheumatism. Fowler’s 
solution is the one of choice. Mothers and nurses, 
in giving Fowler’s solution, should note that when 
the child has pains in the abdomen, diarrhea, foul 
breath, vomiting, and puffiness under the eyes, it 
should be discontinued for two or three days. In 
that case, when beginning to give it again, start 
with the minimum dose, and increase as before. 

Some children can take only small doses of arsenic; 
this should be remembered by mothers who have the 
care and treatment of such cases. Many children 
cannot take more than four or five drops of Fow¬ 
ler’s solution three times a day. The prescribing 
of the rheumatic remedies and arsenic should be 
done by a physician. 

The way arsenic is generally given, is to in¬ 
crease the dose one drop every twenty-four hours; 
starting with one or two drops at the first dose, 


Page Three Hundred Ninety-eight 



TRAINING OF INFANTS AND CHILDREN 


and it is given three times a day after meals. The 
combination with the rheumatic treatment is rarely 
given in larger doses than 10 to 12 drops, and when 
it is necessary to stop the treatment, the dose is 
reduced one drop each day. As soon as the case im¬ 
proves, the medication should be gradually with¬ 
drawn, and after the symptoms have disappeared, 
the restricted diet should be continued for some 
time. 

Every mother should bear in mind that when a 
child has rheumatism or chorea, it is susceptible 
to recurrent attacks, and she should take her child 
to a physician whenever she notices involuntary 
muscular twitching. Children that have had rheu¬ 
matism and chorea should only be allowed meat once 
every second day, and but very little sugar and 
sweets; allow no candy. 

As a preventive to another attack, give a 
child six years old, three grains of bicarbonate 
of soda three times a day for five days; then omit 
it for ten days, and repeat. By regulating the 
diet, giving the bicarbonate of soda solution, 
keeping the child out of school and very quiet, and 
sufficient outdoor life, the recurrence will, in 
all probability, be prevented. 

Paragraph 966 

MENINGITIS. 

Meningitis is an acute infectious disease 
that affects the covering of the brain, the brain 
tissue and the spinal cord. It often occurs in epi¬ 
demic form, and several children in one family will 
become affected, or possibly only one person in 
the family. It is very acute and may terminate 
fatally in a few hours. The child may appear in 
perfect health, and suddenly be taken with dizzi¬ 
ness, vomiting, and severe headaches at the back 
of the head, with high fever. The child may become 
drowsy or even delirious. After this condition 
lasts for a few hours, or days, the patient passes 
into a stupor and delirium, with the head thrown 
back, and the muscles of the back more or less rigid. 
Such a condition is a full picture of the disease. 

It may be very mild or severe. 


Page Three Hundred Ninety-nine 


LECTURES OF INTEREST TO WOMEN 


Temperature may reach from 105 to normal or 
sub-normal, and while the temperature is normal, 
the child plays and seems to be in fairly good 
health. When the temperature rises again, the 
child complains of headache and drowsiness. It is 
irritable and rejects nourishment. The typical 
signs of meningitis are not always present in 
every case. 

Paragraph 967 

NURSING TREATMENT: The most that can be done 
for meningitis is to nourish the patient and lessen 
his discomfort. Warm packs or bath at 105 degrees 
Fahrenheit will help to lessen the cerebral blood 
pressure, and the child should not remain in the 
bath longer than three minutes. The hot pack is 
the best and the most successful. Blankets are 
wrung out of water at 110 degrees Fahrenheit and 
wrapped around the child’s body from the waist down. 
These hot packs may be repeated every half hour for 
three hours; then after a period of rest for two 
hours they may be repeatd again every half hour 
for three hours. 

To give children, suffering with meningitis, 
the proper amount of nourishment is quite a prob¬ 
lem because the child may refuse the food, or it 
may not be able to swallow. The best way to 
administer food in such cases is by the stomach 
tube or gavage and this should be employed when other 
means fail. The younger the child, the greater the 
success you will have with forced feeding. Every 
six hours is often enough to give nourishment. 

Completely peptonized whole milk is usually 
given in quantities suitable for the age. If the 
child will not take nourishment after food has been 
administered in this way, the gavage may be kept up 
indefinitely. 

Paragraph 968 

The general nursing, keeping the patient as 
quiet as possible, seeing that the bowels keep reg¬ 
ular, together with the administration of the medi¬ 
cines as prescribed by the physician, is about all 
that can be accomplished in the treatment and care 
of meningitis. 


Page Four Hundred 


TRAINING OF INFANTS AND CHILDREN 


After a case has recovered, the Board of Health 
will thoroughly disinfect the room. Remember 
that everyone connected with the case must strictly 
obey the rules of quarantine in order to prevent the 
spread of this frightfully contagious disease. 

After ten days or two weeks have passed, and 
the child is making a satisfactory recovery, our 
efforts should be directed towards maintaining the 
nutrition of the affected muscles. Electricity is 
of value in stimulating the muscles, but someone 
who is familiar with the action of the Faradic or 
the Galvanic current should administer the treat¬ 
ment, and the ordinary shop batteries should not 
be used promiscuously. 

Someone skilled in massage should give the 
affected parts a thorough treatment each day. 

When it is impossible to obtain such services, the 
mother or nurse will give some relief to the affected 
muscles by kneading and rubbing them. Splints and 
braces should be used as needed. 

NOTE—The drug treatment for this class of 
cases has accomplished but little, and we question 
if the drugs that are generally prescribed do not 
do more harm than good in the way of annoyance to 
the child. Local applications, such as blisters or 
ice packs to the spine, give the patient the same 
irritation. Medicine that is taken internally 
often causes indigestion and impairs nutrition. 
Good nursing is of as much value as the adminis¬ 
tration of drugs. The only thing that we can hope 
for, in regard to a case under your care, is that 
the infection is mild and will not terminate 
seriously, and that the patient will make a com¬ 
plete recovery. 

i 

Paragraph 969 

STAMMERING AND STUTTERING. 

Stammering applies to the affection of speech 
when the child is scarcely able to pronounce 
words at all. Stuttering is that in which the child 
makes sounds, the repetition of the consonant at 
the beginning of a word; such as, c-c-c-cat. Both 
conditions are caused by nervousness. It occurs 


Page Four Hundred One 


LECTURES OF INTEREST TO WOMEN 


more frequently in boys than in girls. Some authors 
believe that it is sometimes hereditary. It becomes 
persistent after five or six years of age. Up to 
that age it is generally transitory, and lasts only 
a short time during some disturbance of the nervous 
system. 


Paragraph 970 

TREATMENT. To relieve the nervous condition, 
and instruct the child how to talk properly, is the 
line of treatment that is most effective. Teach the 
child, when it begins to talk, to say its words 
slowly and to pronounce them distinctly. A child 
who is in the habit of stammering must not associate 
with anyone affected with the same habit, on account 
of a child’s wonderful power of imitation. It 
should be kept in the best of health, free from all 
nervous excitement, and never allowed to talk when’ 
in a hurry. 

Scolding the child for this defect in speech 
is wrong, and will accomplish nothing. Several 
times during the day have the child take deep 
breaths, holding them for a few seconds, then let¬ 
ting them out slowly. This gives the child control 
over respirations, which will be of great help in 
correct pronunciation. 

The child who stammers should be instructed 
to take a full breath before beginning a sentence. 
It should be taught to utter the vowel sounds slowly 
and without hesitation-—-first in a whisper and then 
out loud. When syllables, words, and then sentences 
are pronounced in a slow rhythmical way—that is, 
when children sing or recite in concert—stammering 
is not very likely to occur. When a child makes a 
mistake, it is best to have it stop at once and re¬ 
peat it slowly. 

The treatment and cure of stammering requires 
continuous and careful watching. It also requires 
a great deal of patience on the part of the mother, 
and recovery is generally slow. When possible, it 
is always recommended to send such children to some 
good institution especially maintained and oper¬ 
ated for the cure of stammering. 


Page Four Hundred Two 


TRAINING OF INFANTS AND CHILDREN 


Paragraph 971 

SELECTION AND CARE OF THE SICKROOM 

The room should be large, airy, light and 
pleasant. It should be as quiet as possible. 

The ordinary bedroom, without too much fur¬ 
niture and hangings, is convenient for ordinary 
sickness, but when there are any of the contagious 
diseases to be cared for the room should be stripped 
bare of all hangings, carpets and upholstery. The 
furniture should consist of a light bedstead, one 
chair and a table. 

Clean the walls and woodwork by wiping with a 
wet cloth wrung out of bichloride solution 
(1-4000). Keep all sick-rooms at a temperature of 
70 degrees. 

Avoid sweeping. If only a mild case of sick¬ 
ness and there is carpet on the floor, clean with a 
carpet sweeper or vacuum cleaner. In acute infec¬ 
tious diseases scrub the floor or wipe it up with a 
damp cloth—do not use a broom. Never dust the room 
with a brush; always use a damp cloth with a disin¬ 
fectant solution. Dissolve one tablet of chlorazine 
in a quart of water for the walls and furniture. In 
all cases of sickness let in all the direct sunlight 
possible, unless the rays are too bright for the 
patient’s eyes. 

Paragraph 972 

Bedding, in all cases of sickness, should be 
changed frequently. In cases of contagious diseases 
put the soiled bed clothes into a tub or pail con¬ 
taining a disinfectant solution. Chlorazine solu¬ 
tion is a good one to use for this purpose. 

Towels, napkins and bandages should always be 
clean. They should be taken from the room and dis¬ 
infected and thoroughly boiled after each time they 
are used. All dishes, cups, glasses, spoons, and 
utensils that have been used in the sickroom, should 
be disinfected before they are taken out. When the 
sickness is a contagious infectious disease, they 
should be placed in the chlorazine solution and then 
scalded with hot water. Toys, shears, vases, combs, 
brushes, or anything that has come near the patient 


Page Four Hundred Three 



LECTURES OF INTEREST TO WOMEN 


suffering with contagious disease, should be left 
in the room and disinfected with formaldehyde when 
the case has recovered, or they should be destroyed 
by burning. In all contagious diseases it is well 
to consider that everything carried into the sick¬ 
room has become infected and needs disinfecting 
before being'used elsewhere. 


Paragraph 973 

All foods should be brought into the sickroom 
just before the patient is ready to eat it. All un¬ 
used articles of food should be burned or mixed with 
a disinfectant, bichloride (1-2000). No foods 
should be allowed to remain in the sickroom. Any 
food that has been in the sickroom, must not be used 
by others, or fed to the dogs or cats. 

All the body discharges from the sick should 
be considered dangerous, and great care must be 
taken to avoid infection from the discharges. Such 
discharges include sputum, stools and urine and dis¬ 
charges from the nose. All discharges from the 
bowels and kidneys should immediately be covered 
with a disinfectant solution, and vessels contain¬ 
ing the discharge and disinfectants, after standing 
for half an hour, should be thrown into the water- 
closet. Vessels containing the discharges should 
be thoroughly cleansed with boiling water and a dis¬ 
infectant bichloride (1-2000). If there is no sewer 
connection they should be buried in the ground. 

Care should be taken never to throw them where they 
might contaminate running streams. A sputum cup 
should be used, or old papers, and they should be 
burned. 

Every patient should have a sponge bath regu¬ 
larly, at least once a day, followed by an alcohol 
rub, and change the clothing at the same time when 
this is possible. 

Persons taking care of the patient should 
not sit on the bed or lean against the bed, walls or 
furniture. They should wash their hands with anti¬ 
septic soap (tincture of green soap) after each con¬ 
tact with the patient. 


Page Four Hundred Four 


TRAINING OF INFANTS AND CHILDREN 


Every attendant upon the sick must- secure 
sufficient rest, because no one can do good work in 
caring for a sick person if they, themselves, are 
not in perfect health in both body and mind. 'They 
should be in an active, cheerful condition and care 
and anxiety must be dismissed from the sickroom, if 
possible. 

Nurses should wear washable dresses which 
should be changed frequently. 

The nurse should also be careful not to 
breathe the sick person’s breath. Mothers should 
be careful about kissing their sick children or 
whispering to them with her face close to the 
patient. They should avoid taking the patient’s 
breath into their own lungs. 

The attendants upon the sick should not go 
into the sickroom with an empty stomach, neither 
should they eat or drink in the sickroom. 

The mother or nurse should keep her hands free 
from all discharges from the sick. If the hands 
become accidentally contaminated, wash them at once 
with green soap. Be careful never to touch the 
patient if your hands are scratched, or have any 
sores on them or the skin is broken in any way. Also 
be careful in eruptive contagious diseases, like 
smallpox or scarlet fever, not to come in contact 
with the scales or scabs of the skin. See that all 
insects are driven out of the sickroom. Kill or 
destroy all flies or mosquitoes. 

Now if the above simple rules are thoroughly 
complied with, the patient will have the best chance 
of recovery, and the nurse or mother will prevent 
infection from spreading to other members of the 
family. 

Paragraph 974 

FUMIGATION. 

To fumigate a room after an acute infectious, 
contagious disease, or sickness of any kind where it 
is desired to destroy disease germs, insects or 
vermin, the best preparations to use are formalde¬ 
hyde and sulphur dioxide. The formaldehyde is best 
for destroying germs, and the sulphur mixture is 


Page Four Hundred Five 



LECTURES OF INTEREST TO WOMEN 


best for killing insects. The formaldehyde should 
be used by itself in moist warm air, and the sulphur 
by itself in dry air. To make it effective, good 
fumigators are necessary. The formaldehycLe and 
sulphur fumigators made and furnished by Bauer & 
Black are good ones; full instructions accom¬ 
pany each outfit. Johnson & Johnson also supply an 
excellent outfit, known as Lister’s Fumigators. 

When preparing the room that is to be fumi¬ 
gated with formaldehyde, cracks around the doors 
and windows should be made as tight as possible; 
flues should be closed; all drawers, closets and 
bookcases should be opened, and the bed clothes 
should be spread out, or hung up so as to expose them 
as fully as possible to the disinfecting gas; all 
toys and playthings used by the child should be 
placed in the open. The temperature of the room 
should be about 70 degrees F. and the air moist. 
Before fumigation begins, it is well to boil a little 
water to make the air moist. In all cases sprinkle 
the floor well with water before starting fumiga¬ 
tion. The right amount of formaldehyde to use is 
one ounce per thousand feet of air space. Formalde¬ 
hyde will not have any bad effects on the furniture 
or anything else in the room. 

The air in a room to be fumigated with sulphur, 
to kill insects, should be dry, and the drier it is 
the less injurious the sulphur will be to clothing 
and furniture. It requires one pound of sulphur to 
fumigate a thousand cubic feet of space. This will 
kill flies and mosquitoes within two hours; two 
one-pound fumigators should kill rats within four 
hours. The one-pound fumigator is about the amount 
required for a room 10x12 and of average height. If 
the room is perfectly dry, very little injury will 
be done to the ordinary room furnishings. Sulhpur 
has a tendency to injure fabrics and furnishings 
in the room, but the injury will be less if the room 
is perfectly dry. Metal fixtures should be given 
a thin coating of vaseline; delicately colored fab¬ 
rics, or any plants, should be removed from the room. 
Plants should be removed whether using sul¬ 
phur or formaldehyde. 


Page Four Hundred Six 




TRAINING OF INFANTS AND CHILDREN 


When it is necessary to fumigate a room, it 
should be done thoroughly and properly. It pays 
to take no chances in matters of this kind, because 
it means making the room, in which a patient with in¬ 
fectious disease has occupied, safe for others to 
use. The time required to fumigate a room, either 
with formaldehyde or sulphur, is about twelve hours; 
that is, the fumigation is generally made in the 
evening, and the room opened up the next morning. 

Paragraph 975 

ABORTION. 

By the term ‘‘abortion,’’ we mean the death 
of the foetus before the end of the third month. It 
is a very common occurrence, because statistics 
show that fifty per cent of the married women 
have one or more abortion. The cause in every case 
cannot be definitely given. Diseases that lead 
to an unhealthy condition of the lining membrane 
of the uterus is one cause; displacement of the 
uterus, or female diseases in general, are other 
causes. Such constitutional diseases as syphilis, 
lead and gas poisoning, occasionally cause abor¬ 
tion; also diseases of the heart, liver and kidneys 
will cause an abortion. 

The first sign that an abortion is liable to 
occur, and one that a woman would notice, is a hemor¬ 
rhage, especially when followed by irregular inter¬ 
mittent uterine contractions. They are similar 
to labor pains, being expulsive, and cause the ovum 
to be expelled. As soon as the hemorrhage and pains 
begin, the patient should go to bed immediately 
and keep perfectly quiet. If blood clots are passed, 
they should be saved for the physician’s examina¬ 
tion. By going to bed and keeping quiet, a threat¬ 
ened abortion may often be avoided. 

Paragraph 976 

NURSING TREATMENT: As a rule, women, when 
having an abortion or miscarriage, treat the case 
indifferently, and do not consider it serious. 

Here a great mistake is made, as the ill health of 
many a patient can be dated from the time she had 
an abortion. She should have the same care and 


Page Four Hundred Seven 


LECTURES OF INTEREST TO WOMEN 


treatment as if it had been a full time child. She 
should remain in bed until the discharge has ceased. 

The after care is practically the same as 
we give to the lying-in patient. She should be 
kept scrupulously clean. All pads should be thor¬ 
oughly sterilized, and special attention should be 
given to the diet, sleep and ventilation of the room. 
Never give a douche in such cases, unless ordered by 
the physician. Unless abortion has been very com¬ 
plete, it is always necessary that a woman should 
have a currettement. This is a safeguard in all 
cases. It is very important, and should not be 
neglected. 

In treating a case of threatened abortion, as 
mentioned, the patient should be put to bed and 
kept there until the bleeding has ceased for at 
least four or five days. If there is any constipa¬ 
tion, give a very mild cathartic—one dram of 
Kasagra—at bedtime, and an enema each morning. 
When all symptoms have ceased, the patient may be 
allowed to get up, but should be kept very quiet. 

She must avoid any excessive exercise, and if after 
being up, the hemorrhage returns, she should call 
her physician immediately. 

In treating and caring for all cases of 
threatened abortion, we should act on the theory 
that the ovum is still living, and our aim should 
be to bring it to full term. If an incomplete abor¬ 
tion does'occur, and it is necessary for the 
physician to empty the uterus, he will do a currette¬ 
ment under the most antiseptic precautions. After 
the currettement, it is necessary for the patient 
to remain in bed after the lochia has ceased for a 
few days, and follow out the same treatment as given 
after the birth of a full term child. 

Miscarriage is a term applied to the expulsion 
of the foetus from the uterus, between the begin¬ 
ning of the fourth month and the sixth month. A 
miscarriage is not as common as an abortion, and 
it is not so difficult in these cases to tell whether 
abortion is complete or not. If the ovum is ex¬ 
pelled, the patient or nurse usually keeps both the 
foetus and placenta for the doctor to examine. 


Page Four Hundred Eight 




TRAINING OF INFANTS AND CHILDREN 


The nursing care of the patient for abortion, 
miscarriage or premature birth is practically the 
same as if labor took place at full term. A great 
many women do not realize the necessity of the 
proper care and attention which they should receive 
during such a critical time. Many women ruin their 
lives, or ruin their health, by treating such 
cases indifferently, and we often see as much 
indifference displayed by the husband as we do 
by the wife. 

A case of abortion, miscarriage, or premature 
birth, improperly nursed or managed, only means 
suffering, poor health and added expense in the 
future. Every case of abortion should be consid¬ 
ered a serious matter. An experienced physician 
should be consulted in such cases, as the future 
health of the patient depends upon how and when the 
currettement is performed. As we have mentioned, 
the trained physician and the trained nurse can 
manage and care for an obstetrical case better than 
one untrained, and the same is true in a case of 
abortion. 


Paragraph 977 
PUBERTY. 

Puberty is that period in life in which the 
young girl develops into womanhood. It generally 
occurs between the thirteenth and fifteenth year. 
It occurs earlier in warmer countries than it does 
in cold climates. Heredity is also a factor in de¬ 
termining the time of puberty. Environment and 
hygienic surroundings play an important part in 
determining the age of puberty. 

The physical changes that lead up to puberty 
are general in their development and not fully com¬ 
plete, as a rule, until the age of twenty, and it is 
at this time in a woman’s development that she be¬ 
comes sufficiently matured to become pregnant; 
therefore, girls should not marry until the full 
physical development of womanhood has been reached 
and the pelvis and its organs are matured. It is a 
mistake for girls to marry in their teens and give 
birth to children during these years. Mothers should 


Page Four Hundred Nine 


LECTURES OF INTEREST TO WOMEN 


therefore be taught that puberty does not mean fit¬ 
ness for marriage. They should realize this fact 
and instruct their daughters not to marry until the 
proper time. 

Plato says, ‘ ‘A woman may bear children to the 
State at twenty years of age.’’ This change that a 
girl undergoes during puberty makes her more grace¬ 
ful, changes her voice, enlarges her hips and 
breasts and both the external and internal genera¬ 
tive organs are developed when menstruation ap¬ 
pears, and the child changes into womanhood. 

Parvin says, ‘‘The girl passes into woman¬ 
hood, puts away childish things, turns from frivol¬ 
ous amusements, from the toys and playthings, from 
rude sports in which she has found pleasure. She 
enters a new life, has new thoughts, desires and 
emotions. Heretofore she had lived solely in and 
for the present, but the future with its lights and 
shadows, its hopes and fears, marks a large part of 
her life. She is more sensitive, more reserved and 
manifests a modest dignity, giving an exceptional 
respect. Her individuality becomes more manifest, 
her sense of duty stronger and her ambitions become 
greater.* * 

Every mother should realize that this is a 
critical time in the life of her daughter, whose 
future health and usefulness depends largely upon 
her mode of living during this period. The future 
burdens of the home maker require a sound and vig¬ 
orous constitution; in other words, perfect health, 
which cannot be obtained without strict attention 
to the care of the body. 

Her diet should be simple and wholesome. The 
character and the amount of exercise carefully regu¬ 
lated. Over-study should be strictly forbidden, 
especially during the menstrual period. We find 
more physical wrecks that are due to over-study and 
mental over-strain, during puberty, as the result of 
our present systems of education, as conducted in 
our schools and colleges, than from any other one 
cause. 


Page Four Hundred Ten 


TRAINING OF INFANTS AND CHILDREN 


Paragraph 978 
MENSTRUATION. 

Menstruation, or the monthly sickness as it 
is generally called, is characterized by a bloody 
discharge from the uterus. It begins at puberty and 
ceases with the menopause. It is generally absent 
during pregnancy and while the child nurses. The 
local symptoms, in normal cases, are backache and 
feeling of weight or fullness in the pelvis. The 
general symptoms manifest themselves in the way of 
flashes of heat, chilliness, loss of ambition, and 
often lack of appetite. Digestion is interfered 
with more or less, and diarrhea, accompanied with 
irritation of the bladder, is noticed in some cases. 
The breasts are often swollen and painful. Some¬ 
times dark circles appear under the eyes. Some women 
suffer more or less with headache during menstrua¬ 
tion; in others, acne will appear on the face. 

There is a congested condition that takes 
place in the pelvic organs. They become enlarged 
and gorged with blood, and the vagina is intensely 
congested and assumes a violet color. When the 
. menstrual flow appears, this congested condition is 
relieved and lessened in severity, or it may dis¬ 
appear altogether. The beginning of the flow, in 
normal cases, is composed of mucous streaked with 
blood, and when it becomes well established it con¬ 
sists of pure blood mixed with mucous. As the flow 
begins to subside, the blood lessons, and it again 
becomes more mucous in character. It is dark in 
color, and does not form clots. Various diseased 
conditions may alter the character of the flow 
to most any degree. 

Menstruation occurs, on an average, about 
every twenty-eight days, or thirteen times each 
year; yet every woman is a law unto herself, and 
there is no fixed time for menstruation to occur in 
every case. Some women menstruate every two week$, 
others only two or three times a year, yet they ar& 
perfectly well. In normal cases, during the first 
year of menstrual life, the flow is often very ir¬ 
regular; may be absent one or two months at a time 
after it first appears, or it may occur once or twice 


Page Four Hundred Eleven 




LECTURES OF INTEREST TO WOMEN 


at varying intervals before it becomes thoroughly 
established. The flow generally lasts from three to 
six days—no fixed time, because in some individuals 
it lasts longer than it does in others. The average 
amount of blood lost at each menstrual period is 
from six to eight ounces, yet it may be more or less, 
and the woman may be perfectly well. The average 
length of menstrual life is from thirty to thirty- 
five years. 


Paragraph 979 

NURSING CARE. The general care that a woman 
should take during menstrual period are common sense 
principles and the general laws of hygiene. During 
the first twenty-four hours of flow, the pelvic 
organs are intensely congested, and during this time 
a woman should remain in her room in bed, or lie on 
a sofa, and her duties should be as light as pos¬ 
sible. At no time during the flow should she take 
active exercise. Cold baths in any form should be 
avoided. She should not sit in draughts or be ex¬ 
posed to the weather in any way. 

The laws of cleanliness should be strictly 
enforced. A woman menstruating should take a gen¬ 
eral sponge'bath of tepid water and soap daily, and 
the external organs should be cleansed two or three 
times a day with warm water and soap. Napkins should 
be changed frequently and not allowed to become 
saturated. In normal cases, vaginal injections 
should not be employed while a woman is flowing un¬ 
less ordered by a physician for medical reasons. 


Paragraph 980 

PAINFUL MENSTRUATION. Painful menstruation 
is a condition whereby women suffer more or less 
general and local discomfort during the menstrual 
period. The majority of women are afflicted in this 
way, and it is caused by a neuralgia or pelvic con¬ 
gestion, undeveloped genital organs, or an obstruc¬ 
tion. The neuralgia, inflammation of the pelvic 
organs, and obstruction, are probably the three most 
common causes. Anything that undermines the nervous 
system has a tendency to cause painful menstruation. 


Page Four Hundred Twelve 


TRAINING OF INFANTS AND CHILDREN 


We find that constitutional diseases, habits, 
and environments are important factors. These con¬ 
ditions cause an exhausted state of the nervous 
system. Mental over-work, like our modern methods 
of education, which require such a mental strain, 
has a great deal to do with placing the nervous 
system in such a condition that the result is pain¬ 
ful menstruation. 

Any inflammatory condition, or inflammation 
of the uterus, tubes, or ovaries, or a displaced 
uterus, will cause painful menstruation. One of 
the common causes is obstruction of the opening into 
the uterus, and in these cases the pains are very 
severe until the flow starts. The cause of the ob¬ 
struction may be a bend in the canal, or it may be 
contraction of the muscles. 

A patient suffering with painful menstrua¬ 
tion will have symptoms according to the cause. It 
differs a great deal, and some patients have pain 
before the flow starts, others during the menstrua¬ 
tion, and others after it stops. The pain is gener¬ 
ally located in the abdomen, in the pelvic cavity, 
and low down in the back, or it may even extend down 
the thighs. The character of the pain also varies. 
It may be constant, intermittent, remittent, fixed, 
shooting, expulsive, labor-like, sharp, dull, 
bearing-down, heavy and dragging. 


Paragraph 981 

NURSING TREATMENT. The successful treatment 
of painful menstruation depends upon the recogni¬ 
tion and removal of the cause. Administration of 
stimulants and morphine as a routine treatment 
should be condemned, because they are not curative, 
and there is danger of the patient becoming addicted 
to their use. There are a great many things that a 
patient can do .to relieve such conditions; such as 
rest, diet, care of the bowels, clothing, vaginal 
douches, change of residence, and the rest cure. 
Physical rest is important and the patient should 
remain quiet during the flow, preferably in bed. 

Between the periods a woman should take plenty 
of exercise in the open air and sunshine. The nature 


Page Four Hundred Thirteen 


LECTURES OF INTEREST TO WOMEN 


of the cause of the painful menstruation must, how¬ 
ever, be considered, and patients that have any 
heart trouble, serious pelvic inflammation, of 
diseased condition of any important organs, should 
not be allowed to take violent forms of exercise. 
The diet should be carefully regulated and easily 
digested foods should be given. Keep the kidneys 
active by having the patient drink plenty of pure 
water. Constipation must be given proper attention 
and laxatives like Kasagra, alternating with saline 
laxatives, are especially beneficial. 

Bathing: The skin must be kept active by 
daily bathing of the entire body. Hot sitz baths 
often give great comfort and relief to the patient, 
and are especially recommended in acute neuralgic 
conditions. Oftentimes a full hot bath from fifteen 
to twenty minutes will be followed by great relief, 
and if given at the beginning of menstruation, be¬ 
fore the attack, it may even avoid it or at least 
lessen its severity. 

Clothing should be worn in such a manner, and 
of sufficient weight, to protect the body from 
sudden changes of temperature. The clothing should 
not constrict the waist, and it is a good idea to 
wear a flannel bandage over the adbomen. 

DOUCHES. Hot vaginal douches of plain sterile 
water are of the utmost importance in the treatment 
of painful menstruation. Especially is this true 
when the cause is due to neuralgic and pelvic con¬ 
gestion or inflammation. They should be given be¬ 
tween the periods, as well as at the time of the 
attack. Persons suffering from nervous exhaustion 
should take the rest cure. 

DRUG TREATMENT. There are a great many reme¬ 
dies recommended which relieve the pain during 
menstruation. Different drug houses manufacture 
various combinations of drugs, and some of the good 
ones are: Lupulin Compound (Upjohn), Buckley’s 
Uterine Tonic, Hayden’s Viburnum Compound. These 
preparations can be taken between the menstrual 
periods three or four times a day, and oftener in 
severe cases. During the flow, when the pain is so 
severe, they can be taken every hour until relieved. 


Page Four Hundred Fourteen 




TRAINING OF INFANTS AND CHILDREN 


Hayden’s Viburnum Compound is a liquid, and gives 
best results when taken in a little hot water; a 
teaspoonful every half hour to two hours as re¬ 
quired. 

Cases of painful menstruation should be cor¬ 
rectly diagnosed and the appropriate treatment 
given. Any of the above remedies can be taken in 
connection with the hygienic treatment and fairly 
good results obtained. If a case of painful men¬ 
struation is not relieved by the above treatment, a 
physician should be consulted to ascertain the exact 
cause and give the case the proper medical at¬ 
tention. 


Paragraph 982 

MENOPAUSE. 

The change of life is that period in which a 
woman ceases to menstruate and bear children. It 
generally occurs between forty-five and fifty years 
of age. Cases are on record where menstruation 
stopped at the age of twenty-two years and continued 
over the eightieth year. The change generally comes 
on gradually and continues from two and one-half to 
three years, or even longer. Sometimes it is very 
brief and sudden; that is, it is regular up to a 
certain time, then stops and never returns. Certain 
conditions, like typhoid fever, cholera or malaria, 
sudden grief, sudden fear, may cause the sudden 
cessation of menstruation. 

The entire system undergoes more or less of a 
physical change during this period in a woman’s 
life. The nervous and digestive systems are 
affected more or less. Probably the first symptom 
that a woman has of the change of life is the stop¬ 
ping of the menstrual flow. In most cases it is 
gradual, and instead of the menstruation occurring 
at the regular time, it will be delayed. 

The most marked symptom is the disturbance in 
the circulation, giving the sudden sensation of heat 
over the face and neck, or over the entire body, 
followed by profuse sweating and feeling of chilli¬ 
ness. Patients going through the change will also 
often have the sensation of fullness in the head, 


Page Four Hundred Fifteen 


LECTURES OF INTEREST TO WOMEN 


indistinct vision, headaches, sleeplessness, ver¬ 
tigo, fainting spells, cold hands and feet, buzzing 
noises in the ears, nose-bleed, hemorrhages from 
the gums or palpitation of the heart. 


Paragraph 983 

NURSING TREATMENT: The nursing treatment 
consists in keeping the patient’s health in the best 
possible condition by careful attention to the laws 
of hygiene. Special attention should be directed 
to the condition of the bowels. See that they are 
regular in order to prevent a congested condition, 
which would occur if bowels become sluggish. The 
action of the kidneys should be carefully watched, 
as well as the bowels. The patient should drink 
plenty of water in order to keep the kidneys well 
flushed. The patient’s diet should be simple and 
nutritious. All highly seasoned or highly spiced 
foods should be forbidden; exercise in the open air; 
a cool sponge bath, spray or plunge should be taken 
every morning before breakfast; and once or twice a 
week the patient should be given a full hot bath 
just before retiring at night. 

Paragraph 984 

PROLAPSE OF THE BOWELS OR RECTUM. 

In young infants, there is more or less pro¬ 
trusion of the bowel, but as a rule, it need not 
cause the mother any anxiety. It will generally be 
retained as the child grows older. There is a 
prolapsed condition of the bowels sometimes which 
is very marked, and occurs in cases of severe 
diarrhea; or straining during a bowel movement, 
caused by constipation, or in weak and delicate 
children. 

When it is only slight, the lining membrane 
of the bowel is pushed out every time the bowels are 
opened with the slightest straining effort. It 
forms a purplish-red ring just outside of the open¬ 
ing, but it can be easily pushed back, or it goes 
back by itself after a little time. 

In other cases, where the prolapse is more 
marked, not only the lining membrane of the bowel, 
but the bowel itself may become prolapsed several 


Page Four Hundred Sixteen 


TRAINING OF INFANTS AND CHILDREN 


inches with every movement of the bowels. If a 
prolapsed condition continues, it causes more or 
less pain and discomfort. After such an extensive 
prolapse has occurred, it is generally repeated 
with more or less frequency. 

Paragraph 985 

NURSING TREATMENT. The first thing to do is 
to replace the prolapse. Lay the child on its 
stomach or back, and the protruding bowel should be 
gently pushed back with the finger, using a rubber 
surgical glove if you have one. The bowel should 
first be well lubricated with vaseline, as well as 
the glove or finger. 

In*some cases, it will assist greatly by hav¬ 
ing an assistant elevate the buttocks to a marked 
degree. To prevent the prolapse from recurring, 
great care should be taken not to allow the child to 
become constipated, and avoid all straining. 

When the bowels move, the buttocks should be 
pressed together, in order to support the rectum, 
and if the child can be taught to have the bowel 
movements lying on its back, using a bed-pan or 
diaper, it will be of great advantage. When the 
toilet is used, the seat should have a very small 
opening, so as to give support to the parts. This 
will have a tendency to prevent prolapse of the 
bowel. Cold bathing of the parts is very useful. 

If the mother or nurse will give the case 
proper treatment and care, as outlined, they can, in 
most cases, prevent or cure the prolapsed condi¬ 
tion. Some very bad cases need an operation, and in 
such cases a surgeon should be consulted. 

Paragraph 986 

SOLUTIONS 

No. of Grains per Ounce 
4.6 grains to the ounce equals 1% solution 

9.2 grains to the ounce equals 2% solution 

23.4 grains to the ounce equals 5% solution 

42.9 grains to the ounce equals 10% solution 

100.3 grains to the ounce equals 20% solution 

253.5 grains to the ounce equals 40% solution 

302.5 grains to the ounce equals 50% solution 


Page Four Hundred Seventeen 


LECTURES OF INTEREST TO WOMEN 


SOLUTIONS—Continued 
No. of Grains per Pint (16 oz.) 

1-500 requires 14:56 grains per pint (16 fluid oz.) 
1-1000 requires 7.30 grains per pint (16 fluid oz.) 

1-2000 requires 3.65 grains per pint (16 fluid oz.) 

1-3000 requires 2.43 grains per pint (16 fluid oz.) 

1-4000 requires 1.82 grains per pint (16 fluid oz.) 

Paragraph 987 

HEAT UNITS OR CALORIES. A calorie is the 
amount of heat necessary to raise the temperature of 
1 Kilo 1° C. The determination of the heat energy 
expressed by a given number of calories can be ap¬ 
plied in estimating the food requirement for in¬ 
fants. The caloric value of 1 ounce of 4 per cent 
milk is 20; 16 times 20 calories equal 320 calories 
to a pint, or 32 times 20 calories equal 640 calories 
to 1 quart. 

Paragraph 988 

The caloric values of different foods are 


given in the following table: 

Food 1 ounce— Approximate Caloric Value. 

Cream (16 per cent),....... 54 

Milk (4 per cent cream)... 20 

Milk (2 per cent cream). -. 15 

Milk (1 per cent cream).1.12 

Milk, fat free.... 10 

Whey . 6 

Condensed Milk.....132 

Buttermilk. 10 

Albumin Milk...... 13 

Malt-soup Extract 80 

Malt-soup (formula as given).... 22 

Milk-sugar (by weight) .. 117 

Cane-sugar (by weight) . 117 

Malt-sugar (by weight). 110 

Barley flour (by weight).. 102 

Rice flour (by weight) .:...102 

Wheat flour (by weight).102 


Page Four Hundred Eighteen 




















TRAINING OF INFANTS AND CHILDREN 


FOODS AMOUNT- CALORIES 

Applesauce..,..-...I ounce ... 30 

Bacon..„„„..1/6 ounce. 30 

Bread.Average slice . 80 

Butter..1 pat (1/3 ounce) .A. 80 

Buttermilk.1 ounce . 11 

Cane-sugar.,,.1 ounce ....'.........120 

Carrot...1 ounce . 13 

Cereal (cooked).:.1 heaping teaspoonful .... 50 

Cereal water (oatmeal)....! ounce...— - - 3 

Chymogen milk..1 ounce.-. 21 

Cow’s milk....1 ounce. .1. 21 

Crackers..'...•..1 ounce.114 

Cream (16 per cent). X ounce. 54 

Custard.1 ounce. 60 

Dextrimaltose....1 ounce.110 

Egg..1 (2 ounces)——. 64 

Egg (white).1 .-. 14 

Egg (yolk).1 . 50 

Flour...1 ounce.100 

Gelatin.-1 ounce. 50 

Human milk..1 ounce..•. 21 

Keller’s Malt Soup.:..l ounce...* ----- 25 

Malt (extract).1 ounce. T . r ........ 89 

Meat...1 ounce.-50 - 70 

Milk-sugar..1 ounce.:.130 

Potato...1 medium size . 90 

Rice (boiled).1 tablespoonful . r ... 90 

Skimmed Milk.1 ounce. 11 

Soup (chicken)..1 ounce. 15 

Spinach...:~1 ounce..... 8 

Toast.Average slice . 80 


Paragraph 989 

One heaping tablespoonful of cane-sugar 
equals 1 ounce; 3 level tablespoonfuls of milk-sugar 
equal 1 ounce. All ingredients measured by table¬ 
spoons or teaspoons are measured level. To measure 
a spoonful, fill the spoon and level it off with the 
back of a case-knife. 


Page Four Hundred Nineteen 































































LECTURES OF INTEREST TO WOMEN 


TABLE OF MEASURES. 


4 saltspoons ..equal 1 

2 teaspoons. ’’ 1 

3 teaspoons....!...-. ’’ 1 

VA dessertspoons . ’ ’ 1 

2 tablespoons . ’ ’ 1 

3 dessertspoons .. ’ 9 1 

6 teaspoons. ’’ 1 

8 drachms .' ’ ’ 1 

2 ounces . ’ ’ 1 

8 ounces..I.~ ’ ’ 1 

16 tablespoons —. ’ ’ 1 

2 ordinary teacups . 9 9 1 

2 pints .. ’ ’ 1 


teaspoon 

dessertspoon 

tablespoon 

tablespoon 

ounce 

ounce 

ounce 

ounce 

wineglass 

cup or tumbler 

cup 

pint 

quart 


Paragraph 990 


QUANTITY OF FOOD FOR FIRST YEAR. 


AGE. 


AMOUNT. 


1 to 7 days.. 

2 weeks. 

3 weeks... 

4 to 8 weeks .... 

2 months . 

3 to 4 months.... 

5 months .. 

6 months . 

7 to 10 months 

11 months. 

12 months. 


1 to 2 ounces 

2 to 2F 2 ” 

2 to 3 

2A to 4 ” 

3 to 4 

3 to 5 ” 

4 to 6 

5 to 8 

6 to 8 

6 to 9 

7 to 9 


Paragraph 991 

TABLE OF APPROXIMATE EQUIVALENT MEASURES: 

To know the equivalent measures is very important, 
especially from a nurse’s standpoint. If you knov* 
that 1 minim equals 1 drop of water, and 1 minim 
equals 2 drops of tinctures, spirits, or wines, it 
is of great value. The following is a table for . 
comparison: 

1 minim equals 1 drop of water, or two drops of 
tinctures, spirits, or wines. 


Page Four Hundred Twenty 


























TRAINING OF INFANTS AND CHILDREN 


30 minims equals Yz fluidrachm, or 1 coffespoonful. 
60 minims equals 1 fluidrachm, or 1 teaspoonful. 

2 fluidrachms equals 2 teaspoonfuls, or 1 dessert¬ 
spoonful . 

4 fluidrachms equals Vz fluidounce, or 4 tea¬ 
spoonfuls, or 1 tablespoonful. 

8 fluidrachms equals 1 fluidounce, or 2 table¬ 
spoonfuls . 

2 fluidounces equals 4 tablespoonfuls, or 1 wine- 
glassful. 

8 fluidounces equals Yz pint, or 1 tumblerful. 

16 fluidounces equals 1 pint. 

32 fluidounces equals 2 pints or 1 quart. 

8 pints equals 4 quarts, or 1 gallon. 

In measuring minims, it is best that you ob¬ 
tain a small minim graduate glass from your drug¬ 
gist, as very often your physician will prescribe 
medicines to be given in minims or drops. 

Now remember, and do not forget this, that a 
drop is a very variable quantity. It depends al¬ 
together upon the liquid used, or the medicine 
given, and the article from which the drop falls. 
If you are going to give drops, have your druggist 
secure and test for you an accurate medicine 
dropper. This will give 60 drops of water to the 
fluidrachm, or 1 teaspoonful; that is 1 drop will 
equal 1 minim. Most all medicines that are pre¬ 
scribed, which contain alcohol, also whiskey and 
other stimulants, will give about 120 drops to the 
fluidrachm, or 1 teaspoonful-that is 2 drops equal 
1 minim, so if your physician orders a drop of 
laudanum, and you are using a minim graduate glass, 
you would measure only half a minim. You see the 
difference which exists between the drop and the 
minim is a matter of the very greatest importance. 

If the accurate dropper cannot be secured, 
medicine should be dropped from the bottle, with 
the cork partially covering the opening. The 
ordinary medicine dropper sold on the market does 


Page Four Hundred Twenty-one 


LECTURES OF INTEREST TO WOMEN 


not drop medicine properly, as the drop is too small, 
and same can be said in measuring larger doses, 
using teaspoonfuls and tablespoonfuls, because 
they vary so much in size, and the accurate dose can¬ 
not be obtained. 

Every medicine chest should be supplied with 
a perfect medicine dropper, and a 2 ounce glass 
graduate—then there can be no mistakes made. 


Paragraph 992 

DROPS. If a physician orders half a drop to 
be given at a time, you would put 1 drop in 2 tea¬ 
spoonfuls of water, and then you give 1 teaspoonful 
of this at a dose. In like manner, if the physician 
orders half a teaspoonful to be given, you measure 
out 1 fluidrachm, or 1 teaspoonful, add to this 1 
teaspoonful of water, and then give 1 teaspoonful 
of the mixture, which would equal a half a tea¬ 
spoonful of the medicine. Do not try to measure 
a half teaspoonful with a spoon alone, as it will 
be very inaccurate. Always remember that the medi¬ 
cine dropper and glass graduate are two essential 
articles for the administration ■ of medicine to 
children. 


Paragraph 993 

TABLE OF DIGESTION. 


Article of Diet— 

How Prepared 

Time 

, H.M. 

Apples, sour hard. 

.Raw 


2:50 

Apples, sour mellow. 

.Raw 


2:00 

Apples, sweet mellow. 

..Raw 


1:30 

Barley.... 

.Boiled 


2:00 

Brains.—.... 

.Boiled 


1:45 

Beef ..... 


3 to 4 

hours 

Butter. 



3:30 

Beans, pod. 

...Boiled 


2:30 

Bread, fresh white. 

..Baked 


3:30 

Bread, corn . 

.Baked 


3:15 

Beets .... 

.Boiled 


3:45 

Chicken, full-grown . 

..Fricasseed 


2:45 

Custard ... 

.Baked 


2:45 


Page Four Hundred Twenty-two 
















TRAINING OF INFANTS AND CHILDREN 


TABLE OF DIGESTION—Continued 


Article of Diet— 

How Prepared— Time, 

H.M. 

Codfish, cured dried.. 

.Boiled 

2:00 

Cheese, old strong. 

.Raw 

3:30 

Chicken soup . 

..Boiled 

3:00 

Carrots . 

.Boiled 

3:15 

Cabbage . 

.Raw 

2:30 

Cabbage . 

.Boiled 

4:30 

Dumpling, apple. 

..Boiled 

3:00 

Eggs, fresh . 

.Soft boiled 

3:00 

Fish, fresh . 

.Fried or boiled 

3:00 

Gelatin . 

.Boiled 

2:30 

Green Corn and Beans. 

.Boiled 

2:30 

Hash, meat and vegetables. 

..Warmed 

2:30 

Milk. 

.Boiled 

2:00 

Milk. 

.Raw 

2:15 

Mutton.. 

.Boiled or roasted 

3:00 

Oysters, fresh . 

.Raw 

2:55 

Oysters, fresh . 

.Stewed 

3:30 

Oyster soup . 

.Boiled 

3:30 

Pork steak.... 

.Fried 

3:15 

Pork, fat and lean.. 

.Roasted 

5:15 

Parsnips . 

.Boiled 

2:30 

Potatoes, Irish. 

.Boiled 

3:30 

Potatoes, Irish. 

.Baked 

2:30 

Rice .— 

.Boiled 

1:00 

Sago .-.— 

.Boiled 

1:45 

Soup, beef, vegetables, bread Boiled 

4:00 

Soup, marrow bones.. 

.Boiled 

4:15 

Soup, bean . 

.Boiled 

3:00 

Soup, barley . 

.Boiled 

1:30 

Soup, mutton . 

.Boiled 

3:30 

Sausage, fresh . 

.Broiled 

3:20 

Tapioca .. 

.Boiled 

2:00 

Turkey... 

.Roasted 

2:30 

Turnips . 

....Boiled 

3:30 

Veal, fresh . 

.Boiled 

4:00 

Veal, fresh.- 

.Fried 

4:30 


Page Four Hundred Twenty three 






































LECTURES OF INTEREST TO WOMEN 


Paragraph 994 

TIME REQUIRED TO COOK VEGETABLES. 

Asparagus .20 to 30 minutes 

Beets, young . 45 minutes 

Beets, old . 2 to 3 hours 

Cabbage .45 to 60 minutes 

Cauliflower ..20 to 30 minutes 

Celery .20 to 30 minutes 

Carrots .35 to 45 minutes 

Green Peas .30 to 45 minutes 

Green Corn .12 to 20 minutes 

Lima Beans .1 hour or more 

Macaroni .45 to 60 minutes 

Onions .45 to 60 minutes 

Potatoes .25 to 30 minutes 

Parsnips ...30 to 45 minutes 

Rice. 45 minutes 

String Beans . 45 minutes 

Spinach....30 to 45 minutes 

Tomatoes .. 20 minutes 

Turnips . 45 minutes 

Paragraph 995 

FOOD REQUIRED PER POUND WEIGHT. 

Weight of Child. Quantity for Each Feeding. 

11 pounds ...._.4 ounces 

12 pounds .-.4% ounces 

13 pounds ..5 ounces 

14 pounds . bVz ounces 

15 pounds . x .6 ounces 

16 pounds .6% ounces 

17 pounds .......7 ounces 

18 pounds ...7 l A ounces 

19 pounds ...8 ounces 

20 pounds ..8 Vi ounces 

21 pounds ...9. ounces 


Page Four Hundred Twenty-four 

































TRAINING OF INFANTS AND CHILDREN 


Paragraph 996 

DRUGS USED TO MODIFY COW’S MILK. 

LIME WATER. Bicarbonate of Soda, Bicarbonate 
of Potassium, and Citrate of Soda are the four drugs 
used to modify cow’s milk. These are used to neu¬ 
tralize the acidity in cow’s milk and make the 
curds more flocculent. Instead of plain lime 
water, some physicians recommend a saccharated 
solution of lime water—5 to 15 drops to each 
feeding. 

Paragraph 997 

SACCHARATED SOLUTION OF LIME WATER is made by 
taking slaked lime 1 ounce, refined sugar (in 
powder) two ounces, distilled water one pint. To 
make the solution, mix the lime water and sugar by 
trituration in a mortar, place it in a bottle con¬ 
taining the water and shake it occasionally for a 
few hours, having the bottle well corked. Then 
after it settles, separate the clear solution with 
a siphon and keep it in a stoppered bottle. 


Paragraph 998 

BICARBONATE OF SODA SOLUTION is made by 
taking one grain of soda bicarbonate (chemically 
pure) to one-half ounce of water. This is the proper 
strength used for diluting cow’s milk. One table¬ 
spoonful of bicarbonate solution is equal to about 
one tablespoonful of ordinary lime water. Both 
these solutions should be kept in a cool place with 
the bottle tightly corked. Always use lime water 
unless the physician prescribes the soda solution. 


Paragraph 999 

BICARBONATE OF POTASSIUM. In addition to the 
use of lime water and Bicarbonate of Soda, some use 
Bicarbonate of Potassium, using 10 to 15 grains to 
each feeding. Fischer says the potassium is used 
when the infant is fed on cow’s milk, and has colic 
beginning one or two hours after feeding. In these 
cases, Fischer claims the potassium is much better 
than either Bicarbonate of Soda or Lime water. 


Page Four Hundred Twenty five 


LECTURES OF INTEREST TO WOMEN 


Paragraph 1000 

CITRATE OP SODA. Then we use Citrate of Soda; 
about one grain to every ounce of food. The Citrate 
of Soda is valuable in milk mixtures, especially 
during the first month, and is recommended and used 
by Tweedy in the Rotunda Hospital of Dublin. 

Paragraph 1001 

BARLEY WATER may be substituted for lime wa¬ 
ter. It is made by using Robinson’s pearl barley 
flour, or the whole pearl barley. We generally use 
the barley flour, and it is made by adding two tea¬ 
spoonfuls to a quart of water and boil it down to a 
pint; then add sufficient water to make a quart 
and strain it. When made out of whole pearl bar¬ 
ley, add two teaspoonfuls of well washed pearl 
barley to a pint of water, boil to three-quarters 
of a pint and strain. Barley water should be made 
fresh every 24 hours. Unless it can be kept in a 
refrigerator, it is better to make it fresh night 
and morning. 

Paragraph 1002 

LIME WATER is a saturated solution of lime, 
and is made by shaking up unslaked lime with water in 
a clean bottle. Let it stand, and pour off the clear 
fluid. It is better to make lime water than to buy 
it. Lime water tablets can be purchased at the drug 
store. 

Paragraph 1003 

MILK SUGAR can be bought from the druggist. 
The solution is made by putting three tablespoonfuls 
of milk sugar to a pint of hot water. 

Paragraph 1004 

CREAM that has been centrifugalized at the 
dairy contains about 25 per cent of fat, and is gen¬ 
erally too high a percentage of fat for infant 
feeding. Cream that is obtained by setting aside 
fresh cow’s milk, letting it stand for about six 
hours, and then skimming off the cream, contains 
about 15 per cent fat. Whole milk contains about 4 
per cent fat. 


Page Four Hundred Twenty-six 



TRAINING OF INFANTS AND CHILDREN 


Paragraph 1005 

UTENSILS 

Most of the utensils used in preparing baby’s 
food should be of granite ware, as this is more 
thoroughly and easily cleansed. A large pan for 
mixing, which will hold about 2 quarts, and a spoon 
for stirring are absolutely necessary. A funnel 
which'is small enough so that it can be inserted in 
the bottle is desirable. For the cleansing of bot¬ 
tles, a bottle brush must be used. A glass graduate 
should be used for measuring fluids. 

The utensils required for home modification 
of cow’s milk are: 

1 glass graduate, 

1 large porcelain or glass pitcher, 

1 glass funnel, 

1 tablespoon, 

1 Chapin dipper for cream, 

1 deep vessel, 

Hygeia bottles and nipples. 

Paragraph 1006 
GYMNASIUM EXERCISE. 

The mother should appreciate and know the 
value of gymnastic therapeutics, and see that her 
children have the proper training along this line. 
Children as a rule, especially in cities, do not 
have the proper physical foundation, on account of 
the lack of exercise. Gymnastic exercise helps to 
keep the child well, and it is less susceptible to 
disease, on account of the physical body being in 
perfect condition. In the weak and delicate child, 
such exercise is of value in assisting nature to 
regain its normal health. 

Parents who can afford it, should have various, 
kinds of gymnastic appliances at home for their 
children, so that they can have the proper exercise 
under the instruction of competent teachers. The 
management of public schools realize the value of 
proper exercise and have, in connection with their 
schools, excellent gymnasium training. Many times 
the exercise is too much for some of the nervous 
and delicate children, and parents should realize 
this fact. Too much exercise is as bad as too little. 


Page Four Hundred Twenty-seven 


LECTURES OF INTEREST TO WOMEN 


The training in institutions is universal, 
but special private training would have its many 
advantages. When the mother notices that the health 
of her child is not up to the average, and she sees 
these conditions earlier than anyone else, it is 
her duty to see that' the child has proper gymnastic 
exercise, because the abnormal conditions in a 
child can be corrected much easier at the beginning 
of the trouble than later in life. Many a mother 
makes a sad mistake by neglecting such conditions, 
with the idea that the child will outgrow them. 

We believe that parents are beginning to ap¬ 
preciate the value of giving the child a better 
physical foundation, and the necessity for the cor¬ 
rection of any physical defects at the beginning. 

In speaking of the different diseases that are ben¬ 
efited by such exercise at the beginning, we refer 
to cases of malnutrition, constipation, children 
with deformed chest, beginnig of curvature of the 
spine in its various forms, and other diseases 
where gymnastic therapeutics are of great value. 

Paragraph 1007 

SUGGESTIVE THERAPEUTICS. 

In referring to suggestive therapeutics, we 
will say that many progressive physicians, surgeons 
and dentists are taking up the practice with more 
or less degree of enthusiasm, making it a part of 
a fixed and definite therapeutic measure in the 
treatment of disease, and those who are thoroughly 
familiar with the subject cannot deny but that a 
great deal of good has been done for their patients 
along this line. 

We must accept the fact that in recent years 
Christian Science has made great strides and 
secured many followers, and we know there are a 
great many cases cured by Christian Science. Both 
suggestive therapeutics and Christian Science 
place a patient in a suggestive condition, which 
aids greatly in influencing the mind over matter. 

If we take a village that has six or eight 
doctors, and we find two or three of them doing most 
of the practice—what is the reason? Is it because 


Page Four Hundred Twenty-eight 



TRAINING OF INFANTS AND CHILDREN 


these certain individuals have a better medical 
knowledge, or is it because of their personality? 

A thorough investigation will invariably give the 
following results: that there is practically no 
difference in the medical or surgical ability of 
the physicians, but the successful men are endowed 
with, and practice, suggestive therapeutics. They 
may not do it knowingly, but in nine times out of 
ten this is the actual reason for their success. 
The person who has made a thorough study of the 
qualifications of a successful practitioner tells 
us that it is two-thirds personality, and one-third 
medical knowledge. 

Today we find many good teachers of suggestive 
therapeutics, many good able men practicing the 
science in the profession, and such conditions were 
unheard of until recent years. A physician who is 
master of the situation, and practices it intelli¬ 
gently, is enabled to obtain excellent therapeutic 
results. It brings the physician and patient closer 
together, which otherwise is impossible, thus 
giving more efficient service. There is no question 
but that the principles underlying suggestive ther¬ 
apeutics are forcing themselves stronger and 
stronger each day to the attention of the medical 
profession, and the great importance of properly 
applying and directing the psychic factor in the 
treatment of disease. 

Every mother, nurse, and physician should 
have a better understanding of the theory and 
efficacy of suggestive therapeutics, and have a 
knowledge of the practical methods of its adminis¬ 
tration, and if the medical profession would only 
master this important subject, and practice it, 
they would stop, to a certain degree, quackery in 
all its forms, which from time to time springs up 
as the result of the rapid evolution in psycho¬ 
logical development. 

The medical profession realizes the influence 
of the mind over the body, and the relation between 
thought and matter, in a most convincing manner, 
and the physician who takes advantage of this fact, 
and uses it in connection with his knowledge of 


Page Four Hundred Twenty-nine 


LECTURES OF INTEREST TO WOMEN 


medicine, enjoys the confidence and appreciation 
of his patients. He relieves many patients who 
need no medicine or surgery, yet are vainly 
crying to the medical profession for help. We 
are fully aware of the fact that a physician, from 
the standpoint of popularity, will not speak out 
frankly and honestly on this subject, feeling that 
it might cast a reflection upon his intelligence. 

We simply make these suggestions to bring 
the mother’s and nurse’s attention to this import¬ 
ant subject*, and if the mother, nurse and physician 
will only accept the principles underlying sug¬ 
gestive therapeutics, and practice it, with a thor¬ 
ough knowledge of the facts on which it is based, 
we will be well paid for giving the subject space in 
‘‘Lectures of Interest to Women.’’ 

Every mother practices suggestive therapeu¬ 
tics with her children in her home every day, and 
she directs and influences her child by her mental 
attitude towards it. The training and develop¬ 
ment of the child is largely nothing more than sug¬ 
gestive therapeutics. The excitable, nervous, 
irritable mother who jumps and shouts, wrings her 
hands when a child accidently falls, or does any¬ 
thing that causes the mother to act in this manner, 
only imparts the same nervous and excitable condi¬ 
tion to the child. How much better for the child 
if, when it gets hurt, the mother, in a calm and 
gentle way, will say to the child: ‘‘No that did not 
hurt very much,’’ instead of making out how awful 
the accident was. 

Then you notice callers and visitors who go 
into a sick room, and begin to say to the patient: 

‘ ‘How bad you look; my that doctor cannot be doing 
you any good; you just look worse all the time.’’ 

Do you think that is encouraging and pleasing to the 
sick patient? The trained nurse occupies the same 
position with her patient as the mother does with 
her children. The nurse who enters the sick room 
with a smile and cheery word, and always makes 
suggestions to the patient for brighter and better 
things, instead of dwelling continually upon her 
sickness, is the successful nurse. 

Page Four Hundred Thirty 



TRAINING OF INFANTS AND CHILDREN 


How much more welcome is the physician who 
sits down and goes over the case, explaining it in 
a way that is intelligent to the patient, gives the 
proper suggestions as to the recovery and the 
giving of medicine prescribed; what the medicine 
is given for and what it is going to do. By going 
into sufficient detail to give the patient full 
confidence that he is master of the situation, he 
is giving the patient a wonderful boost to overcome 
the diseased condition, by placing the mind of the 
patient in the right attitude. The relations be¬ 
tween the mother and child, the nurse and her patient, 
and the physician in his practice, is nothing more 
than suggestive therapeutics applied in some form, 
together with proper medical science. 


Paragraph 1008 

A WORD TO THE NEIGHBOR. 

This book was purchased by its owner for her 
own study, to be used as a reference and guide, and 
to have in her home in case of emergency. She is 
liable to need it at any time. If you borrow it, bear 
this in mind, and return it as soon as possible. 

Many times we impose upon our neighbors through 
neglect, and cause them much inconvenience. 


Paragraph 1009 

HOW TO DRAPE A PATIENT FOR THE SECOND AND THIRD 
STAGE OF LABOR. 

The most unique way of doing this, is to pre¬ 
pare two sheets in the following manner: One should 
be folded once; the other should be split in the 
center, and fold one end of each strip back about 
three feet and sew it along the sides, making a sort 
of a stocking. After they are sterilized, they are 
applied in the following manner: 

Take the sheet that is doubled and pin it 
around the patient, just under the breast, and let 
it fold over the abdomen as much as it will; then 
take the stocking slips, put the feet in the pockets, 
and bring the long strips up over the patient’s 
legs, one for each leg. The strips can be pinned 
together over the abdomen, including the sheet 


Page Four Hundred Thirty-one 



LECTURES OF INTEREST TO WOMEN 


that is around the patient. This covers the patient 
completely, and gives a sterile drape that will 
stay in place, giving plenty of room for delivery. 

After labor is complete, unpin the sheet 
that is around the body, and remove it from under 
the patient, including the stocking slips, leaving 
the sheet on the table or bed perfectly clean, as 
the Kelly pad is placed under this sterile sheet, 
and they are all removed together; that is, the 
drape sheet, Kelly pad and stocking slips. 

Paragraph 1010 

SEXUAL LIFE. 

Of this delicate subject, we feel that we are 
duty bound to make some mention, and that it is the 
duty of every married couple to become broader, and 
better educated along these lines. We do not hesi¬ 
tate to say that ignorance of this subject creates 
more family discord than any one subject we know 
of. Mothers should be able to advise their daugh¬ 
ters, and fathers, their sons, on sex hygiene, 
when they are preparing to be married, instead of 
letting them start life in ignorance on such an 
important subject. 


Paragraph 1011 

SEX CONTROL. 

The pre-determination of sex has been a fav¬ 
orite topic for speculative theorizing, but we 
know of no plausible theory that has yet been ad¬ 
vanced that is applicable to a majority of 
cases, and the sexes of the children that are born 
continue to be in about equal proportion. There 
are authors who claim that the sex of a child can 
be regulated, but so far we have failed to find 
any convincing evidence of their theory. 


Paragraph 1012 

HOME MEDICINE CABINET SHOULD CONTAIN. 
SURGICAL SUPPLIES: 

% lb. Cotton (surgical). 

K doz. 2-in. gauze bandages. 

% doz. 1 yard package plain gauze. 


Page Four Hundred Thirty-two 



TRAINING OF INFANTS AND CHILDREN 


5 yds. 1-in. 0. Z. Adhesive plaster. 

2 Medicine droppers (straight). 

1 No. 12 A. soft rubber catheter. 

1 No. 7 A. soft rubber catheter. 

1 Fountain Syringe. 

1 Hot water bag. 

1 Bed-pan. 

1 Rectal tube. 

DRUGS FOR LOCAL USE: 

Yz pint alcohol. 

2 oz. Lysol. 

4 oz. Turpentine. 

4 oz. Liquid Green Soap. 

1 oz. Iodine. 

2 tubes Unguentine for burns. 

1 tube Oxide Zinc Ointment. 

1 bottle Bichloride tablets (small blue). 

Yz lb. Boracic Acid crystals. 

3 oz. Camphorated oil. 

1 bottle of Infant Glycerine Suppositories. 

2 oz. Liq. Albolene and Pinoleum compound 

for cold. 

12 Menthol compound tablets for gargle. 

DRUGS FOR INTERNAL USE: 

Yz lb. Epsom Salts. 

1 package Abbott’s Saline laxative for 
bowels. 

50 Dosimetric Trinity granules No. 1 for 
fever. 

1 bottle Segraphin tablets for bowels. 

50 Calomel gr Ya for adults. 

50 Calomel gr 1/10 aromatic for children. 

4 oz. Castor oil. 

50 Peptenzyme 5 gr tablets for stomach. 

100 Anti-constipation granules. 

50 Intestinal 5 gr Antiseptic for stomach. 
50 Anodyne for Infants. 

50 Calcidin 1/3 tablets for colds for 
children. 

4 oz. Abortussis Cough mixture. 

24 cold preferred mulford for adults. 

1 small bottle Phillips’ Milk of Magnesia. 
12 Headache tablets. 


Page Four Hundred Thirty-three 



LECTURES OF INTEREST TO WOMEN 


Paragraph 1013 

HOME MEDICAL TREATMENT. 

It is not our aim to teach mothers or nurses 
to be physicians or druggists; that is, that they 
should be able to diagnose and give medical treat¬ 
ment to patients without first consulting their 
physician, but many times it is impossible for the 
physician to come immediately when called; or sick¬ 
ness may begin in the night, at a time when a 
physician cannot be secured, and in rural districts 
the distance is so far for the physician to travel, 
which often causes delay in his coming, that it is 
very necessary that the home medicine cabinet 
contains remedies that will give first aid to all 
common ailments, of which the mother should be 
familiar, so that she can give the necessary relief 
in cases of accident or sickness until the .physician 
arrives. 

The following drugs, prescriptions, and 
directions accompanying each, are given with this 
aim in view, and any mother who will become familiar 
with these remedies and their administration, can 
give them as they should be given, and she will be 
able to care for her children intelligently. 

Paragraph 1014 

CALCIDIN (Abbott’s). Calcidin is of special 
value in croup, sore throat, bronchitis, pneu¬ 
monia, influenza, cold in the head, and all 
catarrhal conditions of the respiratory tract. The 
tablets should be black in color; if they are gray, 
they have lost their strength and are of no value. 
Calcidin is made in 1/3 to 5 grain tablets. For 
children under two years old, give 1/3 to 1 grain 
tablet every fifteen minutes to two hours as 
needed; over two years, give 1 grain tablet. Mash 
up the tablet in powdered form, and give it in a half 
teaspoonful of water as directed. 

Paragraph 1015 

AGARICIN, gr 1-12 pills (Abbott’s). This 
drug is used to arrest night sweats and excessive 
perspiration from any cause. In adults give four of 
the 1-12 gr. granules as the initial dose. It should 


Page Four Hundred Thirty-four 


TRAINING OF INFANTS AND CHILDREN 


be given three hours before the expected sweat. 

The dose may be increased until the desired effect 
is maintained; that is, six, eight, or ten of the 
granules may be given if necessary, or the dose of 
four granules may be repeated every four to six 
hours as required. 

Paragraph 1016 

ANODYNE FOR INFANTS, (Waugh). This formula, 
known as Infant’s Anodyne, is indicated in pain and 
restlessness, due to indigestion, teething, etc., 
in children. Four granules dissolved in sixteen 
teaspoonfuls of water, 1 teaspoonful can be given 
to an infant every 15 to 30 minutes to effect; 
larger doses according to age. 

Paragraph 1017 

TRIPLE BROMIDES that are made by Burroughs & 
Welcomb, are put up in large glass tubes, and the 
wafers are dissolved in a half a glass of water and 
taken three times a day for nervousness. This is the 
dose for adults, children in proportion. It is of 
value when given in treatment of nervous conditions 
of children, like holding the breath, etc. Dose is 
according to age of the child. Being given in the 
solution, it is very easy to give a child the cor¬ 
rect amount, following the rule for dosage accord¬ 
ing to age. 

Paragraph 1018 

KASAGRA. Kasagra is a preparation of Cascara 
that is used as a cathartic, and is given in 1 or 2 
teaepoonful doses at bedtime. It can be given 
ever y three hours during the day if necessary, and 
then 2 teaspoonfuls at bedtime. It can be given with 
any of the digestives, where it is necessary to have 
a cathartic effect. 


Paragraph 1019 

COLD TABLETS. In treating a cold, it is 
necessary to take a brisk cathartic. Take a liquid 
diet and Cold Tablet No. 2 (Upjohn), 1 every two 
hours until the cold is better. If there is much 
running at the nose, take calcidin, 1 grain every 
hour, in addition to the Cold Tablet. At night take 


Page Four Hundred Thirty-five 


LECTURES OF INTEREST TO WOMEN 


a good hot lemonade and a hot mustard foot bath, or 
a full hot bath on going to bed. 


Paragraph 1020 

RHEUMALGINE is an excellent anti-rheumatic 
medicine, and the adult dose is one or two teaspoon¬ 
fuls every three dr four hours in two or three 
tablespoonfuls of water. This taken in connection 
with salithia and an anti-rheumatic diet, will 
usually give good results in acute or chronic rheu¬ 
matic cases. Rheumalgine is especially valuable in 
the treatment of chorea, as an anti-rheumatic 
remedy, and should be given to children according 
to age. 

Paragraph 1021 

MENTHOL COMPOUND (Abbott’s). This prepara¬ 
tion is very effective in treating throat troubles, 
and makes an excellent gargle and mouth wash. The 
standard solution is made by dissolving one tablet 
in two-thirds of a glass of hot water. It is a very 
beneficial preparation for children, because if a 
little of the solution should^be swallowed, no 
harm will result. 

It is a very valuable preparation, and should 
be freely used in all throat troubles. Its effi¬ 
ciency is increased by adding one or two teaspoon¬ 
fuls of glycerine to the mixture. In septic 
conditions like diphtheria and tonsillitis, the so¬ 
lution may be used double strength, and add suffi¬ 
cient alcohol to make the water 20 per cent 
strength, which would be about one and a half tea¬ 
spoonfuls of alcohol to each ounce of water. 

When children are too young to use the gargle 
or irrigate the throat, menthol compound tablets 
are very simple and effective. All that is neces¬ 
sary to irrigate the throat is a fountain syringe 
and a clean tube for introduction into the mouth. 
Place the child on its side with the head down, and 
mouth resting over a basin. Put two pints of normal 
salt.solution into the fountain syringe, (have' it 
warmed to about a temperature of 90 degrees F) , and 
hold the syringe two feet above the child’s head. 
The solution is allowed to flow in a brisk stream 


Page Four Hundred Thirty-six 



TRAINING OF INFANTS AND CHILDREN 


against the swollen parts, until at least half the 
solution is used. This can be repeated every four 
to six hours. 

Paragraph 1022 

POTASSIUM CHLORATE is a drug of value in ton¬ 
sillitis. One grain may be given every two hours to 
a chiLd one year old, and 2 grains to a child two or 
three years old; 16 grains in the twenty-four hours. 

It is also useful in solutions for canker 
sores and ulcerations of the mouth, and a valuable 
remedy in treatment of thrush. It is an antiseptic 
of moce value than is generally considered. It is 
especially valuable as a mouth wash if the gums are 
spongy and bleed readily. 


Paragraph 1023 

TONSILLITIS TABLET (Abbott’s). This tablet 
makes an excellent formula for the treatment of 
tonsillitis and all acute inflammation of the upper 
respiratory tract, especially when there is fever. 
The combination of the drugs render this tablet 
especially favorable for children. 

It is soluble in water, and can be given in 
solution by using one tablet for every year of a 
child’s age, dissolved in 24 teaspoonfuls of water, 
and give 1 teaspoonful every half hour until the 
temperature subsides, then every two hours until 
the throat trouble is relieved. 

A child under four years of age, suffering 
with tonsillitis, spraying, swabbing, and painting 
the throat with various drugs is of little value, 
because it cannot be done thoroughly, as the child 
must be held by force for such treatment. 

Paragraph 1024 

PHOSPHORUS is as good a remedy for the treat¬ 
ment of rickets as can be given, but it should be 
given in combination with the proper diet. The 
preparation most commonly used is the Oleum Phos- 
phoratum. This is the best form to give to children. 
One drop is equal to 100 grains of phosphorus. For 
a child one year old, give one drop, three times a 
day. After the first and second year, 1 to 2 drops 


Page Four Hundred Thirty-seven 



LECTURES OF INTEREST TO WOMEN 


may be given three times a day. Phosphorus should 
always be given after meals. 

Paragraph 1025 

MIGRAINE (Abbott’s No. 301). Migraine, or 
headache tablets should be kept on hand, as they 
are a good headache remedy, and this combination 
will be most suitable for universal use in such 
cases. A child twelve years old can take one tablet 
every three or four hours as required; for adults, 
one can be taken every fifteen to thirty minutes 
until relieved, then one every four or five hours. 
For older children, it is best to crush the tablet 
into powdered form, and place it in 2/3 of a tea¬ 
spoonful of hot water. This-preparation is not in¬ 
tended for infants or young children. 

Paragraph 1026 

RHEUMATIC (Candler No. 1 Abbott’s). This is 
an excellent combination of drugs for the treat¬ 
ment of acute rheumatism, neuralgia and sciatica. 
It should be taken with plenty of water, and in suf¬ 
ficient doses to obtain the desired results. For 
the first few doses, in severe cases, 2 tablets may 
be taken every three hours; after that, only one 
tablet every three hours. 

Paragraph 1027 

COD LIVER OIL. Cod liver oil is valuable in 
all wasting diseases, and conditions where re¬ 
storatives are required, and it is of special value 
in scurvy. In combination with cod liver oil, ar¬ 
senic and strychnine are most valuable. Hemaboloids 
with arsenic and strychnine, is also an excellent 
tonic. Along with the medical treatment, there is 
nothing more effective in treating infants, than the 
giving of orange juice, one teaspoonful every two 
hours; giving one ounce in twenty-four hours. The 
lime salts are also valuable, and 3 to 5 grains of 
calcium lactate may be given three times a day. 

The above tonics are of value in scurvy to build up 
the system. 

Paragraph 1028 

ANTICONSTIPATION (Waugh), made by Abbott. 
This combination is an excellent pill for treating 


Page Four Hundred Thirty-eight 



TRAINING OF INFANTS AND CHILDREN 


constipation in chronic cases. It is a small dose 
and a sufficient number may be given to get the de¬ 
sired effect; then the dose can be reduced as 
curative results are secured. 3 to 6, or more, of 
the pills should be given three times a day, after 
meals, to produce one daily bowel movement. Con¬ 
tinue taking the required dose each day until the 
bowels move twice, or too freely; then reduce the 
dose, omitting one pill at each dose. Take this 
amount for a day or two, or a week, as the case re¬ 
quires, and then omit another pill. The dose is 
reduced until the patient needs to take possibly 
only one pill every other night, and finally omit 
them altogether. Taking the pills as directed, 
with the proper diet, will generally cure chronic 
constipation. 

Paragraph 1029 

CALOMEL WITH AROMATICS. 1-10 calomel tab¬ 
lets with aromatic flavor is the most pleasing way 
to give calomel, especially to children and women 
with delicate stomachs. One or two tablets are 
given every fifteen minutes for four to six doses. 
In two hours after the last dose, give some saline 
laxative, such as, Citrate of Magnesia or saline 
laxative. 

Paragraph 1030 

DOSIMETRIC TRINITY No. 1 (Abbott’s). This 
particular formula and combination of drugs is 
very useful in fever cases. The adult dose is given 
every half to one hour until the fever is reduced. 
For children, dissolve one pill for each year of 
age in 24 teaspoonfuls of water, and give 1 tea¬ 
spoonful of the mixture every thirty to sixty 
minutes as required. Take temperature every two 
hours. 

Paragraph 1031 

INCONTINENCE (Abbott’s). This combination 
of drugs will be very acceptable to the mother who 
has children that wet the bed. It is very effective 
in treating many forms of this condition. The 
medicine is given as directed in ‘ 4 Incontinence, of 
Urine,’’ given in another part of this book. One 
pill is generally given every three or four hours; 


Page Four Hundred Thirty-nine 


LECTURES OF INTEREST TO WOMEN 


the last dose being given at bedtime. Older children 
may be given a double dose on retiring. Special 
care and attention must be given this class of 
patients. Besides giving the incontinence tablets, 
see articles on ‘‘Incontinence of Urine.’ 5 


Paragraph 1032 

STROPHANTHUS is a heart tonic, and it does 
not irritate the stomach; is used in fever cases 
when the heart is weak. When a child has scarlet 
fever, and the pulse is over 150 a minute during 
sleep, give the child (one year old) one drop of the 
tincture of strophanthus every two hours. It is also 
given in pneumonia when we have the same kind of a 
pulse as we have in scarlet fever. It is also used 
in influenza for a heart stimulant; also in typhoid 
fever. 


Paragraph 1033 

STRYCHNINE is a heart tonic, and is given in 
scarlet fever when the pulse is soft and the heart 
action is slow and oftentimes irregular. The dose 
for a child one to three years is 1/200 grain, and 
from three to six years 1/150 grain. It is given 
every two to four hours. It is also given in pneu¬ 
monia when a heart stimulant is needed for the same 
conditions as in scarlet fever. Strychnine is 
given in influenza for a heart stimulant, and also 
is given in typhoid fever. 


Paragraph 1034 

BORACIC ACID. Boracic acid, made up in a 10 
per cent ointment with cold cream, may be applied 
locally in chicken-pox. It will relieve the itch¬ 
ing, and is of value in preventing local skin in¬ 
fection. It is used as a sponge bath once a day, by 
adding 2 heaping tablespoonfuls to a half a gallon 
of boiling water. Chicken-pox patients should 
not be given a full bath during the active stage of 
eruption. 

Paragraph 1035 

LIQUID ALB0LENE AND PIN0LEUM COMPOUND. This 
is made by adding one teaspoonful of Pinoleum to 
two ounces of Liquid Albolene, and it is used for 
colds in the head and coryza. A few drops is put in 


Page Four Hundred Forty 



TRAINING OF INFANTS AND CHILDREN 


each nostril two or three times a day with a medi¬ 
cine dropper. 

Paragraph 1036 

SOMNOS. Somnos is given when there is loss 
of sleep, and when a patient has insomnia, as we 
often find after any serious sickness or worry. It 
may be used for older children as a sedative and 
anti-spasmodic. It is given 15 minims to one tea¬ 
spoonful for a child, repeated every two or three 
hours in water or milk. Adults take from one 
teaspoonful to a tablespoonful every one or two 
hours. The best way to quiet a nervous patient, and 
produce sleep, and get the best results, is to give 
the first dose one hour before bedtime, and repeat 
on retiring, or within an hour. 

Paragraph 1037 

ABORTUSSIS. This preparation gives to the 
mother, who must rely upon her own judgment, more or 
less, in the care of children, an excellent cough 
syrup. It is a preparation that is indicated 
where there is any spasmodic coughing, like in 
whooping cough, bronchitis, or the effects of 
pneumonia, la grippe, or capillary bronchitis. A 
dose for children is 20 to 30 drops every hour or 
two as required; adult dose from 1 to 3 teaspoon¬ 
fuls. In many cases, a full dose is required in or¬ 
der to get the effect. 

Abortussis is also a good cough mixture for 
influenza, and can be given any time during the 
disease, while the cough is severe and persistent. 

Paragraph 1038 

INTESTINAL ANTISEPTIC (W-A) No. 1 is a tab¬ 
let which contains the sulphocarbolates of Calcium, 
Sodium, and Zinc, 5 grains each, and Bismuth Sub¬ 
salicylate 1/2 grain. The adult dose is one tablet 
dissolved in a half a glass of water every two to 
four hours as required; children according to age. 
For a child under six years of age, dissolve three 
tablets in 8 ounces of sweetened water, and give a 
tablespoonful every three hours until the desired 
results are obtained; follow each dose with a drink 
of water. Between six and twelve years old, dis- 


Page Four Hundred Forty-one 



LECTURES OF INTEREST TO WOMEN 


solve six tablets in 8 ounces of water, and give a 
tablespoonful every three hours as directed. 

Sometimes Intestinal Antiseptic tablets will 
disturb the digestion, and cause a burning sensa¬ 
tion in the stomach. When it does this, give, in 
combination with the Intestinal Antiseptic, Pep- 
tenzyme in the same amount as the Intestinal Anti¬ 
septic . 

This preparation will always be found useful 
when there is any intestinal trouble in children, 
such as diarrhea, or fermentation caused by the de¬ 
composition of foodstuffs in the intestines. When 
there is fermentation present, the medicine will 
cause stools to become black, and as long as this 
condition is present, continue giving Intestinal 
Antiseptic tablets until the stools are free from 
any offensive odor. 

Intestinal antiseptic, in combination with 
peptenzyme, is given in influenza. Begin giving 
this as soon as the tongue becomes coated, and 
continue until it is fairly clean. Give a half grain 
of intestinal antiseptic to 1 1/2 grains of pep¬ 
tenzyme every two hours to a child three to four 
years old. 

Paragraph 1039 

MILK OF MAGNESIA. Phillips’ Milk of Magnesia 
is used almost daily in any household in the care 
of children, and is an excellent preparation for 
general use in keeping the bowels regular. In in¬ 
fluenza, or any of the acute infectious diseases, a 
dose may be given at bedtime. For a child three 
years old, give two teaspoonfuls or more, as 
needed. Milk of magnesia is also added to the milk 
in artificial feeding, in any amount required. A 
small amount may be given with each feeding, or the 
required amount may be given at the last feeding 
at night. 

Paragraph 1040 

CAMPHORATED OIL. Camphorated oil is one of 
the valuable remedies in pneumonia, and is given 
hypodermically. It is especially prepared for 
such use. The camphor is suspended in oil and put 


Page Four Hundred Forty-two 


TRAINING OF INFANTS AND CHILDREN 


up in ampules 1/2 to 2 C. C. It is given in 
pneumonia, bronchitis, and in colds for children, 
also influenza, and any condition where there is 
inflammation of the lungs. Hot camphorated oil is 
also applied as dressing for mumps. 

When a secondary infection of the lungs be¬ 
gins to develop in influenza, give one ampule of 3 
grains of camphorated oil every half to two hours 
as required. Children are given smaller doses ac¬ 
cording to age. 

Paragraph 1041 

DOVER’S POWDER. This is a preparation of 
opium, and is made in proportion of 1 grain of pow¬ 
dered opium, 1 grain of powdered ipecac, and 8 
grains of sugar of milk. In pneumonia, when the 
cough is severe and continuous, for a child one to 
two years old, 1/4 of a grain of Dover’s powder may 
be given. It should be dissolved in at least 2 
teaspoonfuls of water. Give after feeding, and not 
oftener than once in two or three hours. The 
ordinary cough syrups disturb the stomach, and are 
not good in pneumonia. In giving Dover’s powders 
see that the bowels keep regular, as it often 
causes constipation. 


Paragraph 1042 

ANTIPYRIN is a white powder with a somewhat 
bitter taste, and is very soluble in water. It is 
one of the coal-tar preparations, and should be 
given with care on account of its depressing 
effects. It is used in whooping cough in combina¬ 
tion with sodium bromide, which probably gives the 
best combination of drugs for the control of the 
cough and severity of paroxysms. For a child two 
years old, 1 grain of antipyrin and 2 grains of 
bromide of sodium, every two hours, for four to six 
doses during the twenty-four hours, will often give 
great relief. 

When antipyrin and sodium bromide is given 
in whooping cough, the best results are obtained 
when this combination is given for four to six 
days, and then give quinine four to six days; that 
is, alternate, first giving the antipyrin and 


Page Four Hundred Forty-three 


LECTURES OF INTEREST TO WOMEN 


bromide compound for a few days and then the quinin 
for the same length of time. 

Sedatives like antipyrin and sodium bromide 
should not be given in whooping cough at the begin¬ 
ning of the disease; wait until the paroxysms have 
become quite severe and then it will have more 
effect. Little or no medicine should be given dur¬ 
ing the earliest stages of whooping cough. 

Paragraph 1043 

IPECAC. Ipecac is given in several different 
forms, but the one most common, and the one for 
special home use, will be the syrup of ipecac. In 
bronchitis, where there is a dry hoarse cough 
without secretions, 10 drops of the syrup of ipecac 
every half hour to two hours, until the child 
vomits, will sometimes abort the condition in a 
very short time. During the beginning of bronchi¬ 
tis ipecac is often given with castor oil. A child 
from one to three years old will be given 3 drops 
of castor oil and 2 drops of syrup of ipecac every 
two hours. After the third year, 3 drops of syrup 
of ipecac and 4 drops of castor oil every two hours. 
About eight doses should be given in the twenty- 
four hours. 

The benefit of the ipecac and castor oil will 
be accomplished in bronchitis in two or three days, 
when it should be discontinued. 

Later in the disease, after the acute stage 
is over with, powdered ipecac is often given in 
combination with tartar emetic and ammonium 
chlorid. For a child under six months old, a powder 
containing 1/80 grain of powdered ipecac, 1/4 
grain of ammonium chlorid, and 1/150 grain of tar¬ 
tar emetic should be given every two hours; from 
six months to a year, powdered ipecac 1/6 grain, 
ammonium chlorid 1/4 grain, tartar emetic 1/100. 

If the cough is very annoying and severe, 1/8 
grain of Dover’s powder may be added to each dose 
for children under six months, and 1/4 grain for 
children over six months of age. After the third 
year, a child may take 1/20 of a grain of powdered 
ipecac, 1 grain of ammonium chlorid, 1/80 grain 


Page Four Hundred Forty-four 



TRAINING OF INFANTS AND CHILDREN 


tartar emetic. In all cases, about eight doses 
should be given in the twenty-four hours, and if 
the cough demands it, a child three years old can 
be given as much as 1/2 grain of Dover’s powder with 
each powder of powdered ipecac, ammonium chlorid, 
and tartar emetic. The powder should be given in 
two teaspoonfuls of thin gruel or plain water. If a 
tablet can be secured with the proper dose, it may 
be given in place of the powder. The powders or 
tablets are better borne by the child in bronchitis 
than the heavy syrups that are generally used. 

Syrup of ipecac is used to cause children to 
vomit in the beginning of croup. 

Paragraph 1044 

QUININ is a very common and well known drug, 
and needs no comment. It is used for older children 
who have whooping cough and are able to take, a cap¬ 
sule. It must be given in sufficient amount, 12 to 
20 grains in twenty-four hours, as required, for 
children from three to six years of age. Some 
parents may think it is too much to give a child, but 
a smaller amount would have little or no effect. 

The serious drawback in giving it to very young 
children is the bitter taste. The bitter taste of 
quinine is concealed best by the use of chocolate. 
A good preparation is the one made by Mulford. It 
is especially suitable for the administration of 
quinine to children. 

The muriate of quinine is given in influenza, 
and to get the effect, it must be given in large 
doses, the same as for whooping cough. Quinine is 
combined with calcidin in influenza, and is given 
throughout the fever stage. A grain and a half of 
quinine and one grain of calcidin is given every 
two hours for a child three to six years old. We 
believe that quinine has the same influence over 
the infection of influenza as it has in malaria. 

Paragraph 1045 

PHENACETIN is one of the coal-tar products, 
and is used to control fever and relieve pain. It 
is used in typhoid when the fever is high, and the 
child very restless. A child five to eight years 


Page Four Hundred Forty-five 



LECTURES OF INTEREST TO WOMEN 


old may be given 1 to 2 grains of phenacetin every 
three to six hours. It is generally combined with a 
half a grain of citrate of caffe in. It must be re¬ 
membered that all coal tar products are more or 
less depressing, and this should be realized when 
giving phenacetin. 

The conditions that would be most unfavorable 
for the administration of the drug would be any 
inflammation of the heart, or cases of pneumonia 
with heart complications. We believe it is the 
safest and most reliable of its class. When given 
for fever, it generally reduces the temperature 
within an hour; phenacetin is given every six to 
eight hours. 

Phenacetin gives relief for the pain and in¬ 
creases perspiration. It does not relieve severe 
pain, but it does relieve distress and nervous¬ 
ness. It unlocks all secretions, produces a moist 
tongue, and skin. Phenacetin causes the pulse to 
become soft and full. It is claimed that it checks 
the course of fever, and preserves the vital tone of 
the patient. That is one of the reasons why it is 
used in typhoid fever. 

Paragraph 1046 

SWEET SPIRITS OF NITRE is a sedative to the 
circulation and nervous system. It causes sweat¬ 
ing and increases the action of the kidneys. Hare 
says: ‘‘There is probably no drug so widely em¬ 
ployed by the laity as a household remedy which is 
so potent for good, and yet so harmless if wrongly 
used, as is this one. ” 

In scarlet fever, where there is kidney 
trouble, for a child two years old give 5 drops of 
sweet spirit of nitre. It may be given alone or in 
combination with 1 teaspoonful of aconitine mix¬ 
ture; it may be given every two hours. This is to be 
given when there is a lack of sufficient amount of 
urine passed. It is also given in measles. 

Paragraph 1047 

PAREGORIC is a preparation of opium that is 
used too freely among children, and should not be 
given in colic, or when the child is restless, when 


Page Four Hundred Forty-six 


TRAINING OF INFANTS AND CHILDREN 


teething, etc. We caution mothers not to give 
opium to children too freely because they do not 
bear the drug well. When a sedative is required, 
such as for the dry cough in measles, 5 to 8 drops of 
paregoric may be given, and repeated every two or 
three hours if necessary; just give enough to 
control the cough. Paregoric, 5 drops and sweet 
spirit of nitre, 3 drops, may be given every two or 
three hours in measles with good effect. For 
children two years old, as much as 8 or 10 drops of 
paregoric may be given. Usually two or three doses 
given during the night will be sufficient. 


Paragraph 1048 

CODINE SULPHATE. Codine is an alkaloid of 
opium, but it does not arrest secretions in the 
lungs and intestines as does morphine, and seldom 
produces constipation. Codine is highly recom¬ 
mended by the medical profession for nervous con¬ 
ditions; such as, whooping cough, also the dry 
cough of measles. It may be given in whooping cough 
to produce sleep regardless of any other treatment 
that is being used. A child five years old may take 
1/6 grain at bedtime, and repeat during the night if 
the case requires it. For a child eight to twelve 
years of age 1/5 of a grain may be given at bedtime, 
and repeated once during the night if necessary. 
For a child from two to three years of age 1/10 of a 
grain may be given, and repeated not oftener than 
twice during the night. Codine should not be 
continued longer than a week or ten days. 

Paragraph 1049 

SODIUM BROMIDE is a sedative and is used in 
cases of whooping cough and also in measles to 
allay the cough, and is often given in place of 
paregoric. The dose for a child eight months old 
would be 2 grains every two hours, and give four to 
six doses during the twenty-four hours. A child 
fifteen months old can be given 2'A grains every two 
hours; from the fourth to the eighth year, 5 grains 
may be given every two hours. Not more than four to 
six doses should be given during the twenty-four 
hours. 


Page Four Hundred Forty-seven 


LECTURES OF INTEREST TO WOMEN 


It is also valuable in treating convulsions, 
and a child under one year of age may be given 8 
grains of sodium bromide and 2 grains of chloral 
hydrate in solution. It should be given per rectum 
in 4 ounces of mucilage of acacia. After the first 
year, 3 or 4 grains of chloral are to be given, 10 to 
15 grains of sodium bromide. If the convulsions 
are severe, and occur one right after another, it 
may be repeated every two to six hours as required, 
and may be given in smaller doses as long as there 
are any signs of nervous irritability. When a child 
can swallow, the required dose of sodium bromide 
may be given in half an ounce of water and repeated 
every one to four hours until the convulsions are 
controlled. 

Paragraph 1050 

TONICS. 

ELIXIR OF IRON, Quinine and Strychnine is a 
splendid preparation and one of the best all round 
tonics. The adult dose is 1 teaspoonful every three 
hours, to three times a day before meals as re¬ 
quired. 

Paragraph 1051 

HEMAB0L0IDS. Another good tonic is Hemabo- 
loids with arsenic and strychnine. Especially is 
this valuable in cases where the patient is anaemic 
and needs the blood built up. It is an excellent 
blood medicine, and 1 dessertspoonful is given four 
times a day. 

Paragraph 1052 

TRIPLE ARSENIC WITH NUCLEIN TABLETS. (Ab¬ 
bott’s). This is an excellent tonic, similar to the 
Elixir of Quinine, Iron and Strychnine. It is in 
tablet form, and for persons who prefer taking tab¬ 
lets in place of liquids, it is very good. It should 
be taken 1 every three hours or four times a day- 
before meals and at bedtime. 

Paragraph 1053 

INDIGESTION. The following are a few selected 
remedies that are of value in the treatment of in¬ 
digestion and associated conditions with stomach 
trouble. 


Page Four Hundred Forty-eight 





TRAINING OF INFANTS AND CHILDREN 


Paragraph 1054 

ELIXIR PEPSOLAXATONE is of special value when 
there is slight constipation with indigestion. Take 
1 or 2 teaspoonfuls before meals and at bed time. 

Paragraph 1055 

PEPTENZYME is an excellent digestive, and is 
a good remedy when it is desired to give something 
to aid digestion. The dose is 1 or 2 teaspoonfuls 
after meals. Peptenzyme can be bought either in 
liquid or tablet form. The tablet contains 5 grains 
and is about equal to 1 teaspoonful of this Elixir. 

Paragraph 1056 

ELIXIR LACTOPEPTONE is another very excel¬ 
lent preparation to aid indigestion. It is given 1 
teaspoonful before meals and 2 one hour after 
meals. It is often valuable when there is pain 
occurring in the stomach one hour after eating. For 
such cases take peptenzyme at same time. 

CARMENZYM is also an excellent digestive, 
and is of great value when the stomach is sour, and 
there is a sick condition, with a desire to vomit. 

Paragraph 1057 

ESSENCE OF PEPSIN (Fairchild’s). This is to 
be recommended when a good digestive is indicated. 
It is given in doses of one teaspoonful after meals, 
and repeated if necessary. It may be given with 
any of the other digestives. 

Paragraph 1058 

GAS ELIMINANT (Tracy). When there is indi¬ 
gestion, accompanied by a great deal of gas in the 
stomach, this tablet will often afford great re¬ 
lief. It should be chewed up or mashed in powdered 
form. In bad cases of indigestion with gas, take 
one tablet before meals, and two about a half hour 
after meals. 

Paragraph 1059 

UTERINE SEDATIVE AND NERVINE, Candler, (Ab¬ 
bott’s). During the change of life (Menopause), 
women suffer more or less with hot flashes and 
ovarian pains, with severe nervous spells. This 


Page Four Hundred Forty-nine 



LECTURES OF INTEREST TO WOMEN 


preparation is very effective in relieving this 
condition. With proper hygienic surroundings, one 
or two pills, with a little hot water, will give 
great relief. In severe cases, where prompt relief 
is required, two or three pills may be taken every 
two hours for three doses; then one or two pills 
three or four times a day as needed, to maintain 
the desired effect. Keep the bowels regular by 
taking salithia in sufficient amount, in order to 
secure free elimination from the bowels. 

Paragraph 1060 

UTERINE TONIC, Buckley, (Abbott’s). This 
combination of drugs is put up in pill form, and is 
used by thousands of physicians in treating con¬ 
gestive conditions of female organs, and it is con¬ 
sidered as near specific as any combination on the 
market. 

It relieves inflammation of the ovaries, 
painful menstruation, or where the flow is scanty or 
excessive, leucorrhea conditions due to weakness, 
or where there is lack of proper tone to the female 
organs in general. It will do a great deal to 
relieve many of the reflex disorders, such as head¬ 
ache, neuralgia, sharp shooting pains in the limbs 
and back. It is a splendid tonic in these female 
conditions where the system is exhausted from 
over-work, and where the patient is compelled to 
be on her feet constantly, or has passed through 
several pregnancies, or is generally run down. 

For the treatment of such cases, which will 
depend largely upon the conditions, take for imme¬ 
diate relief, 1 pill every two hours for four doses, 
then every three hours to maintain the effect. 

Where it is necessary to take them for some time, 
take one daily three times a day. Always keep the 
bowels regular in any pelvic trouble by using 
saline laxative as directed, and enemas. 

Paragraph 1061 

VAGINAL ANTISEPTIC POWDER (Abbott’s). This 
powder is a mixture of drugs that is very helpful in 
treating any of the catarrhal and congestive dis¬ 
orders of the female genitalia. It is put up in 


Page Four Hundred Fifty 




TRAINING OF INFANTS AND CHILDREN 


tablet form, which makes it very convenient to use 
in the treatment of such cases. 

For a cleansing douche, dissolve two tablets 
in a quart of hot water, and take the injection 
very slowly, retaining it for a few minutes. Where 
there is a great deal of leucorrhea, a stronger so¬ 
lution, twice the strength mentioned above, may be 
necessary. These cases may require a douche two or 
three times a day. 

In leucorrhea, where there is very much 
vaginal discharge, chronic in character, and it 
will require prolonged treatment, it is a good plan 
to insert the tablet well up to, and back of, the 
cervix, and let it dissolve in the secretions, and 
take a plain cleansing douche the next morning. 

When women wish a cleansing douche, or where they 
wish to use medication for an ordinary case of 
leucorrhea, they will find the above very satisfac¬ 
tory. 

The proper way to take a vaginal douche is to 
take it lying down, using'a douche pan, one that has 
a rubber tube connected with it, so that the solu¬ 
tion can run into a jar at the side of the bed. It 
is not necessary to use a douche point. Insert the 
plain rubber tube into the vagina about one and 
one-half inches. Have the bag containing the solu¬ 
tion about four or five feet above the hips. Pinch 
the lips closely around the tube, then release. 
Repeat this every few seconds and each time let 
the solution gush out. This flushing of the water 
will cause the vaginal wall to become thoroughly 
stretched, and the solution will come in contact 
with every part of the vaginal wall and surround¬ 
ing tissue. 

Paragraph 1062 

SALINE LAXATIVE. Saline laxative is a very 
excellent form in which to administer Epsom Salts. 
It is one of the best for general use possibly 
known to the medical profession today, and should 
be in every home medicine cabinet. It is one of the 
best preparations to clean out the Alimentary canal. 
It is put up in effervescent combination, which 
makes it very agreeable to take. In all acute forms 


Page Four Hundred Fifty-one 


LECTURES OF INTEREST TO WOMEN 


and conditions where the Alimentary canal;. is loaded 
with toxine, and a complete evacuation of the 
bowels is required, saline laxative gives best re¬ 
sults . 

The average dose is two heaping teaspoonfuls 
in a half a glass of water several times during the 
day, according to conditions. It gives best results 
when taken on an empty stomach on rising. When it 
is desired to get a marked cathartic effect, two 
teaspoonfuls may be given every half hour as re¬ 
quired. Some patients require more than others. It 
should be taken in sufficient doses to obtain a free 
movement of the bowels. 

The advantage of this preparation is that it 
can be taken at all ages; even nursing babies, either 
breast or bottle fed can take it. It is an excel¬ 
lent preparation to give to children when it is 
necessary to remove from the alimentary canal, un¬ 
digested and decomposing stools. In young children, 
one or two teaspoonfuls can be dissolved in a half a 
glass of water, and then, give a teaspoonful of the 
preparation every hour until the desired results 
are obtained. This is given according to the age 
of fhe child. Ordinarily a level teaspoonful given 
to a child once or twice a day will be sufficient. 

It is a preparation that is pleasant to take, 
and rarely, if ever, causes any griping. Children 
who usually object to taking Epsom Salts will 
take the saline laxative without any difficulty. 

For older children, dissolve 1 heaping teaspoonful 
of the saline laxative in a half a glass of water, 
sugar and lemon juice being added; or grape juice 
and water affords an excellent vehicle. 

Paragraph 1063 

SALITHIA (Abbott’s). Salithia is a prepara¬ 
tion to be used in addition to the treating of 
rheumatism, and has many advantages in such cases, 
as it never nauseates the patient, and does not ir¬ 
ritate the most sensitive stomach. A sufficient 
dose is given, and repeated until the bowels and 
kidneys act freely. In rheumatism, give a tea¬ 
spoonful, dissolved in a large glass of water, an 


Page Four Hundred Fifty-two 


TRAINING OF INFANTS AND CHILDREN 


hour before meals and at bedtime; if the bowels 
move too freely, then not so often. 

TAENICIDE (Abbott’s). This is a preparation 
used for the removal of tapeworms. It is a very simple 
and effective treatment, and can be used with safety 
either in adults or children who may have tapeworm. 
The dose for adults is half the contents of one 
bottle, and repeated in two hours if necessary. 
Children from 10 to 14 years old require half the 
amount given to adults, and under 10 a quarter of the 
amount is given. 

The technic of giving the tapeworm remedy is 
as follows: Warm the medicine by standing the bottle 
in a pan of hot water until the medicine is very 
thin; then give the desired amount in about a half a 
glass of warm milk. Rinse the mouth immediately 
with plain hot milk. The patient should not be per¬ 
mitted to lie down after taking the medicine, but 
should be kept in an erect position, and move about 
the house. The diet the day previous to taking the 
treatment should be very light, and no supper in the 
evening. 

For the treatment to be effective, it is very 
necessary that forced catharsis is obtained, and if 
within two hours after the first dose, there is not 
a marked cathartic effect, the dose should be re¬ 
peated until the cathartic action seems to have 
started. It is of advantage to give an enema of 
strong salt water solution at once. The bowels 
should be allowed to move in a pail of warm water, so 
that the worm may float; it usually comes last. 

Great care should be taken that the head is 
expelled. The pail should be large enough so that 
the patient can sit well immersed in the water, and 
remain in this position until the action is complete. 
This will prevent breakage of the worm, and the pos¬ 
sibility of the head remaining. Carefully look for 
the head with a magnifying glass, if in doubt. When 
the head is retained sufficiently high up in the 
bowel, the worm will grow again quite rapidly, and 
when segments are noticed in the stools the treat¬ 
ment should be repeated. It is necessary to carry 


Page Four Hundred Fifty-three 



LECTURES OF INTEREST TO WOMEN 


out the treatment in detail, as mentioned, in order 
to be successful. 


Paragraph 1064 

SANTONIN AND CALOMEL No. 1 (Abbott’s). San¬ 
tonin and calomel is a good combination of drugs, 
and is used for the removal of round worms. General¬ 
ly in such cases, small doses repeated often act the 
best. Children over six years of age are given two 
tablets every half hour for three or four hours be¬ 
fore retiring; the last dose being doubled; for 
younger children, one at the same intervals. The 
next morning after taking santonin and calomel, the 
patient should be given a good dose of saline lax¬ 
ative early in the morning. 



Page Four Hundred Fifty-four 




TRAINING OF INFANTS AND CHILDREN 


Paragraph 1065 

COMMON ABBREVIATIONS OF MEDICAL TERMS 


Abbreviations 

Latin Word 

English Word 

aa. 

Ana. 

Of each 

aaa. 

Amalgam 

Amalgam 

Ad. 

Ad. 

To 

Ad-2D. 

Ad duas doses 

At two doses 

Ad saturand 

Ad saturandum 

Until saturated 

Ad lib. 

Ad libitum 

At pleasure 

Aq. tepid. 

•Aqua tepida 

Warm water 

Aq. ferv. 

Aqua fervens 

Hot water 

Aq. dest. 

Aqua distillata 

Distilled water 

Aq. font. 

Aqua fontana 

Spring water 

Abs. feb. 

Absente febre 

Fever being absent 

Ad. feb. 

Adstante febre 

Fever being present 

Alt. boris 

Alternis horis 

Every second hour 

Ante cib. 

Ante cibum 

Before food 

Aq. bull 

Aqua bulliens 

Boiling water 

Aq. pluv 

Aqua pluvialis 

Rain water 

Aq. pur 

Aqua pura 

Pure water 

Bull 

Bulliat 

Boil it 

Bene 

Bis die, or 

Bene 

Well 

Bis, i. d. 

Bis in die 

Twice daily 

C. 

Congius 

A gallon 

Cap. 

Capiat 

Take it 

Chart. 

Chartula 

4 small paper (pow¬ 
der) 

Coch. 

Cochleare 

A spoonful 

Coch. mag. 

Cochleare magnum 

x4 tablespoonful 

Coch. parv. 

Cochleare pervum 

4 teaspoonful 

Colent. 

Colentur 

Let them be strained 

Collyr 

Collyrium 

4n eye. water 

Comp. 

Compositum 

Compounded 

Contus. 

Contusus 

Bruised or broken 

Coch. med. 

Cochleare medium 

4 dessertspoonful 

Cum. 

Cum 

With 

C. vin. 

Cyathus vinarius 

4 wineglass 

Div. 

Divide 

Divide 

Dieb.alt. 

Diebus alternis 

Every other day 

Dieb. tert 

Diebus tertius 

Every third day 

Dil. 

Dilue, Dilutus 

Dilute, diluted 

Dim. 

Dimidus 

One-half 

Div. in. par. 

Dividatur in par¬ 

Let it be divided into 

aeq. 

tes aequales 

equal portions 

D. orsdos. 

Dosis 

Dose 

Dur. dolor. 

Durante dolore 

During pain 

E. 

E. or Ex. 

Out of, from 

F. or ft. 

Fiat or fiant. 

Let there be made 

Fol. 

Folium or folia 

A leaf or leaves 

Ferv. 

Fervius 

Hot 


Page Four Hundred Fifty-five 



LECTURES OF INTEREST TO WOMEN 


C" 


COMMON ABBREVIATIONS OF MEDICAL TERMS—Cont. 
Abbreviations Latin Word English Word 
Ft. Chart xij Fiant chartulae Let 12 powders be 



duodecim 

made 

Ft. pil, xij 

Fiant pilulae 
duodecim 

Let 12 pills be made 

Garg. 

Gargarisma 

A gargle 

Gr. 

Granum or grana' 

A grain or grains 

Gtt. 

Gutta or guttae 

A drop or drops 

Haust. 

Haustus 

A draught 

Infus. 

Infusum 

An infusion 

Inf. 

Infusa 

Let it infuse or steep 

Lin. 

Linimentum 

A liniment 

Lot. 

Lotio 

A lotion 

M. 

Misce 

Mix 

Mass. 

Massa 

A mass 

Mist. 

Mistura 

A mixture 

Mac. 

Macero 

To macerate 

Man. prim. 

Mane primo 

First thing in the 
morning 

M. or Min. 

Minimum 

A minim 

Mitt. 

Mitte 

Send 

Non-rep. 

Non repetatur 

Let it not be repeated 

0 . 

Octarius 

A pint 

Om. alt. hor. 

Omnibus alternis 
horis 

Every second hour 

Om. bih. 

Omni bihora 

Every two hours 

Om. 1-4 h 

Omni quadrante 
horae 

Every fifteen minutes 

Opt. 

Optimus 

Best 

Pil. 

Pilula 

A pill or pills 

P. R. N. 

Pro re nata 

As demanded 

Pulv. 

Pulvis, Pulveres 

A powder or powders 

P. aeq. 

Partes acquales 

Equal parts 

Per. 

Per 

Through or By 

P. p. a. 

Phiala prius 

The bottle being 


agitata 

first shaken 

Post. 

Post. 

After 

Q. suff or 

Quantum sufficit 

A sufficient quantity 

q. s. 

Q. lib 

Quantum libet 

As much as pleases 

R. 

Recipe 

Take 

Rad. 

Radix 

A root 

Red. in pulv 

Redactus in 
pulverem 

Powdered 

Rept. 

Repetatur 

To be repeated 

S. or Sig. 

Signa 

Write 

Ss. 

Semis 

The half 

S. A. 

Secundem artem 

According to art 

Simul. 

Simul 

Together 

Sin. 

Sine 

Without 

Sing. 

Singulorum 

Of each 


Page Four Hundred Fifty-six 




TRAINING OF INFANTS AND CHILDREN 


COMMON ABBREVIATIONS OF MEDICAL TERMS—Cont. 


Abbreviations Latin Word 


Solv. 

Sum. 

Tinct. 

T. i. a. 
Tritura. 
Ut dictum. 
Vel. 

Ver. 

Vitel. 


Solve 

Sume 

Tinctura 
Ter in die 
Tritura 
Ut dictum 
Vel. 

Verus 

Vitellus 


English Word 
Dissolve 
Take 

A tincture 
Thrice daily 
Triturate or grind 
As directed 
Or 

Genuine 
Yolk of an egg 


Paragraph 1066 

GLOSSARY. 

A 

ABDOMEN is that part of the body which lies 
between the thorax and the pelvis. 

ABORTION is the interruption of pregnancy, 
and the expulsion of the ovum before the foetus is 
viable. 

ACNE is a small pimple or eruption which some¬ 
times affects the breast or any part of the body. 

AFTER-BIRTH is the placenta with the membrane 
and umbilical cord. 

AFTER-PAINS are the pains due to the contrac¬ 
tion of the uterus after the placenta has been 
expelled. 

AMENORRHEA is the absence of the menstrual 

flow. 


ANAESTHETIC is a drug capable of producing 

sleep. 

ANTISEPTIC is a drug which prevents pus form¬ 
ation or putrefaction. Among the best antiseptics 
are alcohol, carbolic acid, bichloride of mercury, 
lysol, chlorazine and ziratol. 

APNEA means breathlessness from obstruction 
of respiratory functions. Interrupted or suspended 
respiration. 

ATRESIA is the absence of a natural opening 
or passage, as the vagina, uterus, etc., whether 
congenital, or caused by disease. 

AREOLA is the pigmented ring around the nipple, 
and Secondary Areola is a slightly pigmented ring 


Page Four Hundred Fifty-seven 



LECTURES OF INTEREST TO WOMEN 


just outside the areola, sometimes observed after 
the fifth month of pregnancy. 

ATROPHY means wasting or emaciation with loss 
of strength, but without fever. 

ASCEPTIC means in a surgically.clean manner. 

ASEPSIS means free from infection; surgical 
cleanliness. 

ASTRINGENT. Having the power to diminish 
excessive discharges. 


B 

BROMIDE. A salt consisting of a combination 
of bromine with a metallic base, as bromide of 
potassium. All of the bromides have the power of 
allaying nervous irritation and promoting tran¬ 
quility in various disorders. 


C 

CADAVER. A corpse, or dead humani body. 

GASEOSA is the greasy white substance that 
covers the new-born baby. 

CATHARTIC is a drug that increases evacuation 
from the bowels. 

CATHETER is a slender tubular instrument for 
withdrawing fluids from a cavity of the body or for 
distending a passage. 

CATHARSIS. Purgation of a passage from the 
bowels, medically or naturally. 

CAUTERIZE. To burn living tissue. 

CERVIX is the neck, or any neck-like part. 

COLOSTRUM is the first fluid secreted by the 
mammary glands after delivery. It contains less 
casein and more albumin than ordinary milk, as well 
as numerous fatty globules. 

CONCEPTION is the beginning of pregnancy. 

CONGENITAL. Anything existing at birth, such 
as disease, malnutrition, deformities, etc. 

CONVULSION is a spasm; a series of violent 
involuntary contractions, of a muscle or set of 
muscles. 


Page Four Hundred Fifty-eight 



TRAINING OF INFANTS AND CHILDREN 


CORYZA. Acute nasal catarrh. ‘‘Cold in the 
head. ’ 9 

CYANOTIC means a blueness of the skin caused 
by deficient amount of oxygen in the blood. 

D 

DEMULCENT. Soothing medicine or drinks, 
usually of a mucilaginous character. 

DESQUAMATION means the peeling off of skin 
in flakes. 

DYSPNEA means difficult breathing. It is 
caused by anything which interferes with the en¬ 
trance of air into the lungs. 


E 

ECLAMPSIA is a sudden attack of convulsions 
occurring during pregnancy, labor, or just after 
labor. 

ENEMA is a medicine or fluid injected into 
the rectum, either to procure an evacuation from 
the bowels or for nourishment. 

EPISIOTOMY is an incision of the vulvar orifice 
to permit the foetus to pass. 

EXCISE means to cut out or off. 

EXCORIATION. Removal of a portion of the 
skin. A slight wound only abrading the skin. 

F 

FEBRILE. Pertaining to or indicating fever. 

FOETID. Having an offensive odor, particu¬ 
larly the odor of putrefaction. 

FOETUS is the product of conception between 
the end of the third month of gestation and delivery. 
Previous to the end of the third month, the product 
is known as the embryo. 

FORNIX. An arch or vault. 

G 

GAVAGE means forced feeding by placing food 
in the stomach through a tube. 

GESTATION means pregnancy. 


Page Four Hundred Fifty-nine 



LECTURES OF INTEREST TO WOMEN 


H 

HEMORRHAGE is the escape of blood from its 
natural channels. 

HYMEN is the membranous fold which partly 
closes the entrance to the vagina. 

HYPERTROPHY. An increase in the size of an 
organ or part due to increased nutritive activity. 

HYSTERIA is a nervous disease, mainly of young 
women, characterized by lack of control over acts 
and emotions. 

I 

INFECTION is the communication of disease 
from one person to another. 

INSOMNIA is inability to sleep, abnormal 
wakefulness. 

INTRAVENOUS. Within the cavity of a vein. 

INTROITUS is the entrance to the vagina. 

INTUBATION. Inserting a tube in the throat. 

IODIDE. A non-acid combination of iodine 
with another element. 


L 

LABOR is a function of the female organism 
by which the product of conception is expelled 
from the uterus through the vagina into the outside 
world. 

LEUCORRHEA is a whitish discharge from the 
vagina and uterus, commonly called Whites. 

LIGATED. Tied. 

LOCHIA is the vaginal and uterine discharge 
occurring for several days after delivery. 

M 

MENOPAUSE is the change of life; the period 
when menstruation ceases. 

MENSTRUATION is the monthly flow of blood 
from the uterus. 

MISCARRIAGE is an expression used by the 
laity to signify the occurrence of a premature 
interruption of the pregnancy at any time. 


Page Four Hundred Sixty 



TRAINING OF INFANTS AND CHILDREN 


MULTIPARA is a woman who has born several 
children. 


N 

NEURITIS is an inflammation of a nerve. A 
condition indicated by pain or tenderness over a 
nerve-trunk. 

O 

OBSTETRICS is the care of women during preg¬ 
nancy, in childbirth and after delivery. 

ODEMA is a dropsical condition caused by an 
increased amount of fluid within the tissue spaces. 

ORCHITIS is inflammation of the testicle. 

OVUM means egg, the germ-cell after impreg¬ 
nation has taken place; embryo and its membranes. 

P 

PAPULE is a small pimple that is called 
‘ ‘vesicle’ ’ when it is filled with fluid, and 
‘ ‘pustule’ * when it is filled with pus. 

PAROTID GLANDS are the glands situated under 
the ear. 

PERIPHERY. Circumference; bounding line; 
external surface. 

PERISTALTIC. Applied to all movements of the 
interior organs which are independent of the spinal 
marrow. 

PLACENTA is the flesh-like substance in the 
uterus nourishing the foetus, attached to the upper 
part of the uterus during gestation, and connected 
with the foetus by means of the umbilical cord. 

PREGNANCY is the condition of a woman who is 
carrying a child. 

PREMATURE LABOR is the interruption of preg¬ 
nancy after the foetus is viable. 

PRIMIPARA is a woman bringing forth her first 

child. 

PROLAPSE means to fall forward; a falling 

down. 

PUBERTY means to mature; the age of capability 
of re-production. 


Page Four Hundred Sixty-one 



LECTURES OF INTEREST TO WOMEN 


PUTREFACTION means decomposition of animal 
or vegetable matter. 

PUERPERAL is pertaining to child bearing. 

PYLORUS is the inferior orifice of the stomach, 
communicating with the duodenum. 

Q 

QUICKENING is the period of gestation, about 
the seventeenth week, marked by the first percept¬ 
ible movement of the foetus in the utero. 

R 

REGURGITATE. The vomiting of food without 
any effort. 

S 

SALINE is the nature of, or containing, salt. 

SCROTUM. The pouch containing the testicles. 

STASIS is a stagnation of the blood. 

STERILE is to make free from germs. 

SUPPOSITORY is a small mass of conical shape 
whose basis is usually cocoa butter, gelatin or 
glycerine. It is intended to convey medicine to act 
mechanically for either local action or constitu¬ 
tional results. 

SUPPURATION is the process by which pus is 
formed or secreted. One of the terminations of 
inflammation. 

SUTURE. To stitch together the edges of a 

wound. 

T 

TOXEMIA is blood-poisoning. 

TOXIC. Poisonous. 

TRAUMA. A wound or injury. 

U 

UMBILICAL CORD is the naval string, which 
joins the foetus and placenta. 

URETHA is a membrane canal conveying urine 
from the bladder to the surface. 

URINALYSIS is the chemical analysis of urine. 

UTERUS is the womb. 


Page Four Hundred Sixty-two 



TRAINING OF INFANTS AND CHILDREN 


V 

VENOUS STASIS means stagnation of blood in 
the veins. 

VESICLE is the small sac or blister that forms 
on the body in eruptive diseases. 



Page Four Hundred Sixty-three 








SEATTLE MATERNITY HOSPITAL 



This Institution will be the most modern Maternity Hospital in America. 
Equipped with all the latest appliances known to the medical profession for 
the successful treatment of confinement cases, including Nitrous Oxid-Oxygen 
apparatus, Infants Incubators, Lung Motor, X-ray and all other necessary 
equipment. 

With a bed capacity sufficient to accommodate 200 patients per month, 
sleeping porches, sun parlors and six delivery rooms with one operating room. 

The Hospital will be non-sectarian, open to the Medical profession, and 
operated on scientific, professional, ethical and business methods. 


OUR NEW .PROSPECTIVE HOSPITAL BUILDING 

Each department will be in charge of trained nurses and superintendents, 
who have had years of successful experience in maternity hospital work. 

There will be many new features in the nursery and delivery rooms in 
connection with our institution that you do not find in the general hospital. 

CORRESPONDENCE SCHOOL FOR NURSES 

The purpose of this school will be to give the young woman a thorough 
training for professional nursing, and to train the mother in nursing for the 
home. These courses can be studied in the evenings and in spare time, and 
will not interfere with the present employment of the student, thereby en¬ 
abling her to pay her way while taking the course. 

Students who wish may take a post graduate course in practical work in 
the Hospital. 

FOOD AND DIET 

An expert on Dietetics will have charge of this department. The latest 
modern warming ovens will be installed so that the patients’ meals will be 
served hot. 

POST GRADUATE COURSE 

This department will be for physicians and graduate nurses who wish to 
specialize in maternity work. All late scientific methods will be demonstrated. 

RATES 

The moderate rate charged for this high-class service will bring it within 
reach of those heretofore unable to receive hospital service in maternity cass. 










INDEX 


A 

Paragraph I* age 


ABDOMEN, Pains in . 68 37 

ABORTION . 975 407 

Nursing Treatment . 976 407 

Miscarriage . 976 408 

ABORTUSSIS . 1037 441 

ABBREVIATIONS MEDICAL TERMS 1065 455 

ACCIDENTS . 909 359 

Splinters . 909 359 

Cuts anil Bruises . 909 359 

ACETIC ACID . 884 348 

ADENOIDS . 645 247 

When appear . 646 248 

Symptoms . 647 248 

Nursing Treatment . 650 248 

AFTER BIRTH . 173 75 

AFTER-CARE, asphyxia . -171 74 

Confinement . 182 77 

AFTER-PAINS . 227 95 

AGARICIN . 1015 434 

ALCOHOL, disinfectant . 112 53 

Poisoning . 875 346 

ALBUMIN WATER . 700 276 

ANAESTHETIC . 157 70 

ANALYSIS OF MILK . 371 141 

ANODYNE FOR INFANTS. 1016 435 

ANTI-CONSTIPATION . 1028 438 

ANTIPYRIN . 1042 443 

ANTIDOTES FOR POISON . 871 345 

ANTISEPSIS, Meaning of . 93 46 

APPLICATIONS, hot in croup. 634 244 

APPLE SAUCE . 694 266 

APPETITE, loss of . 753 289 

Treatment . 754 290 

APPLICATORS, how to make. 122 56 

ARM FRACTURE . 912 361 

ARSENIC POISONING . 876 346 

ARTIFICIAL FEEDING . 373 142 

After first month. 379 145 

After third month. 380 145 

Amount requireil . 382 146 

Calories required . 381 145 

Change of diet. 393 152 

Constitpation . 418 163 

Details of giving. 378 144 

Dextrimaltose . 385 147 

Explanation of . 383 146 

Formulas from birth. 386 148 

Formula No. 1. 387 148 

Formula No. 2 to 7. 388 149 

Formula, Holt’s . 389 150 

Formula No. 1 to 6. 390 150 

Formula, to Increase . 392 152 

Milk Mixture . 373 142 

Substitute for . 374 143 

How to give . 375 143 

Substitute for Breast . 376 143 

Quantity Required . 377 144 

Mixing Fresh Milk. 397 154 

Patent Foods . 396 153 

Right Combinations . 395 153 

Top Milk Mixtures . 391 152 

ASEPSIS, Meaning of . 93 45 

ASPHYXIATION FROM GAS. 959 392 

ASPHYXIATED CHILD . 162 72 

Oxygen . 163 72 

Treatment . 164 72 

Routine of . 165 72 

Lung Motor . 170 74 

After-care . 171 74 


B 


BARLEY WATER 

BABY, How to Lift . 

Cry . 

BANDAGE . 

BASINS, In Sick Room . 

BASKET, For Baby . 

Contents of . 

BATHS, During Pregnancy . 

In Colic . 

In Influenza ..... 

In Rickets . 

In Scarlet Fever . 

In Measles . 

Infants . 

Premature Infants . 

Sitz ... 

Salt . 

Cold . 

Temperature of . 

Should not be Given. 

Mustard . 

In Eczema . 

BED, Baby’s . 

BED SORES . 

BED WETTING . 

BEEF, Scraped . 

Juice . 

"BEETS, Boiled . 

BICHLORIDE . 

BICARBONATE OF SODA 
BICARBONATE OF POTASSIUM 

BICHLORIDE OF MERCURY. 

BIRTH MARKS . 

BITES, Snake . 

Cat, Dog and Horse. 

Mosquito . 

Insect Stings . 

BLADDER, Irritability of. 

Paralysis of . 

Relieving . 

Catheterizing . 

Solutions used . 

BLOOD POISON . 

BLOOD, Pressure of .. 

Toxemia . 

Eclampsia . 

Rise, Cause of . 

Testing . 

Change in . 

In Typhoid Fever. 

BLUE SPELLS, Cause of 

BOILS . 

Treatment . 

BOTTLES, Care of. 

BORACIC ACID . 

BOWELS, During Pregnancy . 

Care of . 

During Fever . 

How to Move. 

Lying-in Period . 

Massaging .:. 

Regularity of . 

BOW-LEGS . 

BRAN POULTICE . 

BREAD AND MILK POULTICE 
BREASTS, Inflammation of 

Treatment ... 

During Pregnancy .---- 

Caked . 

Engorged . 

Diet for . 

Massage of . 

Treatment for . 

BREAST MILK ... 

BRAIN . 


r a graph 

Page. 

1001 

426 

745 

287 

267 

111 

80 

40 

107 

51 

258 

109 

740 

285 

44 

28 

436 

168 

597 

229 

658 

252 

608 

234 

538 

205 

304 

121 

461 

177 

76 

39 

665 

254 

785 

309 

786 

310 

787 

310 

788 

311 

902 

355 

313 

124 

499 

193 

814 

320 

677 

260 

695 

266 

713 

270 

108 

51 

998 

425 

999 

425 

872 

346 

846 

334 

834 

328 

835 

329 

837 

330 

838 

330 

9 

15 

208 

89 

209 

89 

210 

89 

211 

90 

869 

344 

36 

26 

37 

26 

38 

27 

39 

27 

40 

27 

250 

106 

604 

231 

472 

181 

860 

340 

861 

340 

410 

159 

1034 

440 

28 

24 

206 

88 

607 

234 

412 

160 

205 

87 

422 

164 

411 

159 

920 

364 

796 

314 

795 

314 

893 

351 

894 

351 

10 

15 

199 

85 

196 

83 

215 

91 

197 

84 

198 

84 

200 

85 

478 

186 


I 

















































































































































INDEX 


B 


BRONCHITIS . 

Symptoms . 

Pulse . 

Nursing Treatment 

Temperature . 

Plasters . 

Nourishment . 

Digestion . 

BROTHS, Veal 

Chicken . 

Lamb . 

BRUISES . 

BURNS . 

Preparations to Use 


Paragraph 

613 

614 

615 

616 

617 

618 
620 
621 

690 

691 
699 
909 

840 

841 


Page 

236 

237 
237 

237 

238 

238 

239 
239 

264 

265 
267 
359 
331 
331 


c 

CALCIDIN . 1014 434 

CALOMEL WITH AROMATICS. 1029 439 

CALORIES . 381 145 

CAMPHORATED OIL 1040 442 

CARMINZYM . 1056 449 

CARBOLIC ACID . 873 346 

CARROTS, Boiled . 712 270 

CASEIN, In Milk . 368 140 

CAT BITES . 835 329 

CATNIP TEA . 705 268 

CATHETERIZING, Infant . 303 121 

CAUSTICS . 874 346 

CAYENNE-PEPPER PLASTER 803 315 

CHICKEN-POX . 562 215 

Nursing . 563 216 

Infection of . 565 216 

CHILBLAINS . 890 349 

Treatment . 891 350 

CHEST, Normal Size . 829 326 

CHOLERA INFANTUM . 928 369 

Treatment . 929 369 

CHOLERA MORBUS . 930 370 

Treatment . 931 371 

CIRCUMCISION . 946 382 

CITRATE OF SODA . 1000 426 

CLOTHES, Long .. 741 286 

Short . 742 286 

Time for Changing . 743 287 

CLUB-FOOT . 917 363 

CODINE SULPHATE . 1048 447 

COD LIVER OIL . 1027 438 

COITUS, During Pregnancy . 43 28 

COLD TABLETS . 1019 435 

COLD COMPRESS . 790 311 

COLDS IN THE HEAD 895 351 

Treatment . 896 351 

COLIC . 425 165 

Symptoms of . 426 166 

Treatment for . 430 167 

Changing Position . 434 168 

Colic Cures . 432 167 

Enema for . 427 166 

Feeding, in . 433 168 

Hot Bath . 436 168 

Infant Anodyne . 435 168 

Recurring . 437 168 

Spice Plaster . 431 167 

Stools, Green . 428 166 

White Curds . 429 166 

COLLAR BONE FRACTURE . 911 361 

COLON IRRIGATION IN INFANTS 

When Given .'. 805 316 

Solution Used . 806 316 

Cold Solution . 807 317 

How to Give . 808 317 

Older Children . 809 317 

Position of Infant. 810 317 

Murphy Drop Method. 812 318 

CONCEPTION . 89 43 


Paragraph Pag*.’ 


CONFINEMENT, After-Care. 182 77 

Temperature of Room. 224 94- 

Daily Care . 225 94 

Visitors ... 226 94 

After-pains . 227 95 

When to Leave Bed. 228 95 

Position of Patient. 229 96 

CONSTIPATION— 

During Pregnancy . 29 24 

Treatment .. 30 24 

Diet . 31 24 

Injections .*.. 32 24 

In Artificial Feeding. 394 153 

In Children . 939 376 

Treatment . 940 377 

Drugs . 941 377 

Diet . 942 378 

Exercise . 945 380 

Older Children . 943 380 

CONVULSIONS . 638 245 

Cause . 639 245 

Fatalities . 640 246 

Nursing . 641 246 

Enemas . 642 246 

Diet . 643 247 

CORD, Tying of . 161 71 

Dressing of . 256 108 

Care of .,. 286 115 

Premature Infant . 466 178 

CORSETS, During Pregnancy. 26 22 

COTTON JACKET . 804 315 

CORROSIVE SUBLIMATE . 872 346 

COW’S MILK . 398 155 

CRAMPS, Muscular . 839 330 

CREAM . 1004 426 

CREEP AND WALK . 746 287 

CRIB, Kind of. 314 124 

CROUP . 627 242 

Symptoms . 628 242 

Cause of . 629 242 

Dangers of . 630 243 

Pulse . 631 243 

Nursing Treatment . 632 243 

Applications . 634 244 

Medical Treatment . 636 244 

Clothing . 637 245 

CRY, Baby’s . 267 111 

Attention . 273 112 

Benefit of 268 111 

Cause of . 269 111 

Clothing . 281 114 

Exhausted . 279 114 

Frightened . 278 113 

Hungry . 270 112 

Pain, When in . 272 112 

Position, Change of . 277 113 

Sleepy . 275 113 

Temper . 280 114 

Thirsty . 271 112 

Treatment of . 274 113 

Wet Napkin . 276 113 

CURVATURE OF THE SPINE. 923 365 

CUTS AND BRUISES . 909 359 

CUSTARDS, Plain . 678 261 

Chocolate . 679 261 

Baked . 680 261 

D 

DANDRUFF . 862 341 

DEFORMITIES . 916 363 

Club-foot . 917 363 

Flat Foot . 918 364 

Pigeon-toe . 919 364 

Bow-legs . 920 364 

Knock-knee . 921 364 


II 

















































































































































INDEX 


D 

Paragraph Page 


Hip-joint Disease . 922 365 

Curvature of the Spine. 923 365 

Of Nipples . 53 33 

DELIVERY, Emergency . 160 71 

DEXTR1MALTOSE . 385 147 

DIAGNOSIS, Of Pregnancy . 20 19 

Labor . 140 63 

Scarlet Fever . 529 203 

DIAPER, Square . 824 324- 

DIARRHEA . 438 169 

DIET, During Pregnancy . 27 23 

Bronchitis . 620 239 

Care of . 216 91 

Convulsions . 643 247 

Dinner . 220 92 

Breakfast . 218 92 

Eczema . 903 355 

Engorged Breasts . 215 91 

Incorrect . 752 289 

Liquids . 213 90 

Lunch ... 219 92 

Measles . 539 206 

Nursing Mother . 358 137 

Premature Infant . 455 175 

Pneumonia . 584 223 

Rickets . 657 251 

Scarlet Fever . ; . 524 201 

School . 734 282 

Smallpox . 575 220 

Wine, Value of . 214 91 

Whooping Cough . 548 208 

1 to 10 years. 667 255 

12 to 15 months . 668 256 

15 to 18 months. 669 256 

3 to 10 years . 669 257 

DIETETICS . 505 195 

DIET KITCHEN . 512 197 

DILATATION . 144 65 

DIPHTHERIA . 552 209 

Contagious . 553 210 

Fever in . 559 213 

Infection of . 554 210 

Membrane, Growth of. 555 211 

Nursing Treatment . 556 211 

DISEASES OF CHILDREN. 185 

Of Premature Infants . 469 180 

DISINFECTION . 511 197 

DISLOCATIONS . 915 363 

DISPOSITION, Change in . 8 15 

DOG BITES . 835 329 

DONTS . 739 284 

DOSIMETRIC TRINITY . 1030 439 

DOVER’S POWDER . 1040 443 

DOUCHES . 75 39 

Vaginal . 1061 451 

Cleansing . 1061 451 

LlRESS, During Pregnancy . 24 22 

Premature Infants. 454 174 

DRESSINGS . 104 50 

DRESSING THE BABY . 282 114 

When to . 283 114 

DR. DAVIS, Quotation from. 236 98 

DROWNING . 961 395 

DRUGS TO MODIFY COW’S MILK. 425 

Lime Water . 996 425 

Sacchrated Solution . 997 425 

Bicarbonate of Soda. 998 425 

Bicarbonate of Potassium . 999 425 

DRUGS NOT USED. 221 93 

Not Safe . 242 101 


A Paragraph Page 

EARS AND NOSE . 288 116 

Foreign Bodies In. 775 305 

EARACHE . 852 337 

Treatment . 853 337 

ECLAMPSIA . 38 27 

ECZEMA, In Women . 77 39 

In Children . 900 354 

Treatment . 901 355 

Bath to Give . 902 355 

Diet . 903 355 

Urine . 904 356 

Drugs . 905 356 

EGGS, Soft Boiled . 708 269 

Poached . 709 269 

Coddled . 710 270 

In Milk . 715 271 

ELBOW CUFF, Thumb Sucking. 826 325 

Nail Biting . 828 326 

ELBOW FRACTURE . 912 361 

ELECTRIC SHOCK . 958 390 

ELIXIR OF IRON . 1050 448 

ELIXIR PEPSOLAXATONE . 1054 449 

ELIXIR LACTOPEPTONE . 1056 449 

EMOTIONAL INSANITY . 957 389 

ENEMAS, During Pregnancy . 152 68 

For Infants . 421 164 

In Colic . 427 166 

Different Kinds of . 813 319 

EPILEPSY . 953 386 

Treatment . 954 386 

EPISIOTOMY . 178 77 

ERGOT, When to Give. 177 76 

ERYSIPELAS . 951 384 

Treatment . 952 385 

ESSENCE OF PEPSIN . 1057 449 

ETHER DURING LABOR . 155 69 

EXAMINATION, Pregnancy . 21 20 

Of Infants . 253 107 

During Labor . 143 65 

By Nurse . 135 62 

EXERCISE . 41 27 

During Pregnancy . 57 34 

Gymnasium . 1006 427 

EYES, Infants . 254 107 

Care of . 287 116 

Premature Infants . 463 178 

Eye Strain . 733 282 

Foreign Bodies in . 774 304 

F 

FAINTING . 70 37 

FARINA MILK GRUEL . 687 263 

FEAR . 728 280 

FEEDING BABY . 321 127 

Artificial . 373 142 

After First Month.• 379 145 

After Third Month. 380 145 

Amount Required ..382 146 

Calories Required . 381 145 

Change of Diet . 393 152 

Constipation . 394 153 

Details of Giving . 378 144 

Dextrimaltose . 385 147 

Explanation of . 383 146 

Formulas from Birth. 386 148 

Formula No. 1. 387 148 

Formula No. 2 to 7. 388 149 

Formula, Holt’s . 389 150 

Formula No. 1 to 6. 390 150 

Milk Mixture . 373 142 

Patent Foods . 396 153 

Top Milk Mixtures . 391 152 

Hygiene of . 755 292 

Care of Utensils . 755 292 

Cause of Infection. 755 293 

Rectal . 756 293 


III 























































































































































INDEX 


FIGURE, During Pregnancy . 54 

Abdominal Muscles . 55 

Development . 56 

Exercise . 57 

Massage .,. 59 

Support . 58 

FINGERNAILS, Biting . 827 

Treatment . 828 

Hand-I-Hold Mits . 828 

Elbow Cuff . 828 

FISH AND OYSTER POISONING. 877 

FLAXSEED POULTICE . 794 

FLAT FOOT . 918 

FLY PAPER POISONING. 876 

FOOD, Absorption of . 331 

Kinds of . 333 

Artificial . 362 

Weaning, Used in . 445 

Stale . 507 

FOREIGN BODIES IN EYE. 774 

In Ear and Nose.. 775 

Swallowing . 776 

FORMALDEHYDE . 974 

FORMULAS, From Birth . 386 

Number 1 . 387 

Number 2 to 7. 388 

Holt’s 1 to 6. 390 

FRACTURES . 910 

Lower Jaw . 911 

Collar Bone . 911 

Long Bones of the Arm. 911 

Elbow . 912 

Arm Below Elbow. 912 

Ribs . 912 

Leg Above Knee . 913 

Leg Below Knee. 914 

Splints . 914 

FRECKLES . 845 

FRESH AIR, Scarlet Fever.. 523 

In Whooping Cough . 550 

Hours for . 320 

FROST BITES . 888 

Treatment . 889 

FUMIGATION . 974 

G 

GAS ASPHYXIATION . 959 

GAS, In Sick Child. 483 

In Stomach . 342 

Eliminant . 1058 

GAUZE SPONGES . 121 

GELATIN, Orange . 718 

Prune . 720 

GERMS, In After-care. 189 

GLOSSARY . 

GLOVES, To Sterilize . 101 

Dry Sterilization . 102 

GRADUATE, GLASS . 494 

GREEN PEA SOUP . 692 

GRINDING TEETH . 487 

GRUEL . 711 

FARINA MILK . 687 

GUMS, Sore . 67 

GUM BOILS . 773 

GYMNASIUM EXERCISE . 1006 

H 

HAND-I-HOLD MITS 

For Sucking Thumb. 826 

For Biting Nails . 828 

HANDS, Swelling of. 78 

HARE-LIP . 848 


Paragraph Page 


HEAD, Normal Size. 829 326 

HEADACHE . 851 336 

HEALTHY INFANT . 735 282 

Normal Condition . 736 283 

Weight, Increase in . 737 283 

Fontanel . 738 283 

HEART-BURN . 72 38 

HEAT UNITS OR CALORIES. 987 418 

Caloric Value of Foods. 988 418 

HEGAR’S SIGN, Of Pregnancy . 13 17 

HEMABOLOIDS . 1051 448 

HEMORRHAGE . 176 76 

HERNIA . 935 373 

Umbilical . 936 374 

Ventral .. 938 375 

HICCOUGH ... «23 324 

HIGH CHAIR, When to Use. 744 287 

HIVES . 898 353 

Nursing Treatment _ 899 353 

HOLDING THE BREATH. 821 322 

HOLT'S FORMULA, Milk . 389 150 

HOME TRAINING . 723 278 

HOME STERILIZING . 103 49 

HOP POULTICE . 797 314 

HORSE BITES . 835 329 

HOSPITAL, Necessity of . 235 98 

HOT BATH, In Colic . 436 168 

HOT COMPRESS . 789 31 1 

HUNGRY CHILD _ 270 112 

HYGIENE OF PREGNANCY . 23 21 

HYGIENE OF FEEDING. 755 292 

HYDROCHLORIC ACID . 884 348 

I 

ICE-BAG . 502 194 

ICE PACK . 791 312 

IMPETIGO . 934 373 

IMPERIAL GRAlVfUM . 703 268 

IMPRESSIONS, Maternal .. 46 30 

Nervousness . 47 30 

Emotional . 48 31 

Heredity . 49 31 

INCORRECT DIET . 752 289 

INCONTINENCE OF URINE . 814 320 

Causes of . 815 320 

Treatment . 816 321 

INCONTINENCE TABLET . 1031 439 

INCREASE WEIGHT . 295 118 

Milk Flow, How to__ 345 134 

Total Amount . 350 136 

Total Solids . 352 136 

Fat . 354 136 

Proteids . 356 136 

INCUBATOR . 452 174 

INCUBATION, Period of . 611 236 

INDIGESTION . 1053 448 

INFANTS, Care of . 247 105 

Blood . . 250 106 

Cord . 256 108 

Examination of . 253 107 

Eyes, Care of . 254 107 

First Care . 252 106 

General Condition . 257 108 

Shock . 248 105 

Uterine Contraction .. 249 105 

Length of . 747 288 

INFANT ANODYNE . 435 168 

INFANTILE PARALYSIS . 955 387 

Treatment . 956 388 

INFECTION, In Pregnancy . 96 46 

In Diphtheria . 554 210 

In Chicken-pox . 565 216 

Blood Poisoning . 869 344 

INFLAMMATION, Of Eyes. 892 350 

Of Infants’ Breasts . 893 351 

Treatment . 894 351 


Page 

33 

33 

34 

34 

34 

34 

326 

326 

326 

326 

347 

313 

364 

346 

130 

131 

139 

171 

196 

304 

305 

306 

405 

148 

148 

149 

150 

360 

361 

361 

361 

361 

361 

361 

362 

362 

362 

333 

201 

209 

126 

349 

349 

405 

392 

187 

133 

449 

56 

272 

273 

80 

457 

49 

49 

192 

265 

189 

270 

263 

37 

303 

427 

325 

326 

40 

335 


IV 



















































































































































INDEX 


Cause of 


Cotton Jacket 


Medical Treatment 


INSOMNIA, During Pregnancy.. 

In Children . 

INJECTIONS . 


Round Worms 

Pinworms . 

Tapeworm . 

Treatment . 


ITCHING SKIN 
ITCH . 


JACKET, Cotton 
In Influenza .. 


KIDNEYS, In Pregnancy 

In Infants . 

In Scarlet Fever . 


It 


Anaesthetic 


Dilatation 


Ether . 

Examination . 

Meaning of .... 

Missed . 

Mechanical Device . 

Nitrous Oxide . . 

Responsibility of . 

LAMB BROTH .. 

LAUDANUM POISONING .. 881 

LEAD POISONING ... 

LEG FRACTURE . 

LEUCORRHEA IN CHILDREN .... 

Treatment .. 

LICE . 

Treatment . 


LIME WATER 


In Pneumonia . 

LIVER, Functions of 
LUNCH . 


LUNG MOTOR 
LOCHIA 


LYE POISONING 

LYSOL . 

Use of . 


Paragraph 

Page 

M 



590 

226 


Paragraph 

Page 

597 

229 

MALARIA . 

932 

371 

590 

226 

Nursing Treatment . 

933 

371 

593 

227 

MALTED MILK 

704 

268 

595 

228 

MASSAGE .. 

42 

28 

596 

229 

Bowels .. 

422 

164 

598 

229 

Engorged Breast . 

197 

84 

599 

229 

MASTURBATION 

947 

382 

838 

330 

Treatment . 

948 

383 

64 

36 

MASTICATION OF FOOD 

509 

197 

906 

357 

MEALS, Morning . 

671 

258 

32 

24 

Noon .. 

672 

259 

411 

159 

Evening . 

673 

259 

. 1038 

441 

MEASLES . 

530 

203 

863 

341 

Cause of . 

531 

203 

864 

342 

Signs . 

532 

204 

865 

343 

Temperature . 

533 

20 i 

866 

343 

Rash . 

534 

20:1. 

867 

344 

Complications . 

.. 535 

205 

105 

50 

Nursing of . 

536 

205 

124 

57 

Light and Air . 

.. 537 

205 

885 

348 

Baths . 

538 

205 

. 1043 

444 

Diet . 

539 

206 

74 

39 

MEASURES. Table of . 

989 

419 

858 

340 

MEDICINE CABINET AT HOME 

. 1012 

432 

. 859 

340 

MEDICINE, Correct Dose 

832 

327 



Average Dose . 

833 

328 



How to Give . 

491 

190 

804 

315 

Kinds of . 

492 

191 

r>96 

229 

MEDICAL TREATMENT AT HOME 

1013 

434 

911 

361 

MENINGITIS 

966 

399 

329 

129 

Nursing Treatment . 

967 

400 

698 

267 

Drug Treatment . 

968 

400 



MENOPAUSE . 

982 

415 

1018 

435 

Nursing Treatment . 

983 

416 

35 

25 

MENSTRUATION 

2 

12 



Cessation of .. 

3 

13 

dUZ 

528 

202 

May Continue .. 

4 

13 

921 

364 

Irregular . 

5 

13 



Meaning of .. 

978 

411 



Painful ... 

980 

412 

136 

62 

Treatment . 

981 

413 

158 

70 

Drug Treatment . 

981 

414 

141 

64 

MENTAL WORK for Children . 

732 

281 

140 

63 

MENTHOL COMPOUND 

1021 

436 

144 

65 

MILK SUGAR' . 

1003 

426 

145 

66 

MILK, Breast— 



155 

69 

Drying Up . 

200 

85 

143 

65 

Flowing of .. 

201 

85 

137 

62 

Abnormal . 

202 

86 

88 

43 

Lack of . 

203 

87 

154 

68 

Premature Infant . 

451 

173 

156 

70 

Cow’s, Analysis of . 

371 

141 

138 

63 

Cleanliness of . 

364 

139 

699 

267 

Composition of . 

372 

141 

881 

347 

Casein in . 

368 

140 

883 

347 

Reaction of . 

370 

141 

913 

362 

Selection of . 

. 363 

139 

949 

384 

Packed in Ice . 

365 

139 

950 

384 

Preservations . 

366 

140 

856 

339 

Sugar and Fat . 

369 

140 

857 

339 

Mixing . . 

397 

154 

745 

287 

Boiling . 

. 398 

155 

696 

266 

Modification of . 

399 

155 

1035 

440 

Pasteurization of . 

401 

156 

213 

90 

Sterilization of . 

402 

156 

586 

224 

Home Pasteurization . 

403 

157 

330 

129 

Digestibility . 

405 

158 

219 

92 

Selection of . 

406 

158 

474 

181 

MILK MIXTURE . 

373 

142 

170 

74 

Substitute for . 

374 

143 

187 

80 

How to Give. 

375 

143 

294 

118 

Quantity Required . 

377 

144 

874 

346 

Details of Giving. 

378 

144 

109 

52 

MILK OF MAGNESIA . 

424 

165 

179 

77 

Home Cabinet . 

1039 

442 


V 






























































































































































INDEX 


M 

Paragraph Page 


MIGRAINE . 1025 438 

MISCARRIAGE . 976 408 

MODIFYING BREAST MILK . 350 136 

Increase Amount . 350 136 

Decrease Amount . 351 136 

Increase Solids . 352 136 

Decrease Solids . 353 136 

Increase Fat . 354 136 

Decrease Fat . 355 136 

Increase Proteids . 356 136 

Decrease Proteids . 357 137 

MORPHINE POISONING . 881 347 

MOSQUITO BITES . 837 330 

MORTALITY, In Scarlet Fever ... 518 199 

In Smallpox .. 568 218 

MOTHER AND BABY . 259 109 

MOUTH BREATHING . 822 323 

MOUTH, Premature Infant . 464 178 

In Sick Child ....;. 480 186 

Cleaning of . 510 197 

MORNING SICKNESS . 6 14 

When it Occurs . 61 395 

Treatment . 62 35 

Drugs Used . 63 35 

MUMPS . 560 213 

Nursing . 561 214 

MURPHY DROP METHOD 812 318 

MUSHROOM POISONING . 882 347 

MUSTARD BATH . 788 311 

MUSTARD PLASTER . 792 313 

N 

NAILS, Care of . 289 116 

Biting . 827 326 

NAPKIN (Diaper) . 260 109 

Size of . 261 109 

How Applied . 262 110 

Disposition of . 263 110 

Washing of . 264 110 

Dispensing with . 265 110 

Dressing of . 266 110 

Square . 824 324 

NAVY BEANS . 685 262 

NEIGHBOR, A WORD TO. 1008 431 

NERVOUSNESS . 47 30 

NIGHT TERRORS . 849 336 

Treatment .. 850 336 

NITRIC ACID POISONING. 884 348 

MTRO-Ml RIATIC ACID . 884 348 

NIPPLES, Breast . 31 

Care of .. 50 31 

Treatment . 51 32 

Tender . 52 32 

Deformities . 53 33 

After-care . 192 81 

Bottle .... 158 

Best to Use . 407 158 

Care of . 408 158 

Opening of . 409 159 

NITROUS OXIDE . 156 70 

NUMBNESS . 65 36 

NOSE AND EARS, Premature . 465 178 

Foreign Bodies in . 775 305 

NOSE-BLEED . 842 332 

NOURISHMENT, Sick Child . 495 192 

NURSES’ GRIP, Contents of. 127 59 

NURSING INFANTS . 194 82 

Care Before . 284 115 

Time for .. 335 131 

Effect of . 336 131 

First Three Days . 337 132 

Hours for . 338 132 

Regularity of . 339 133 

Giving Water. 340 133 

Cleanliness . 341 133 


Paragraph Page 


Position for . 343 134 

Flow of Milk . 344 134 

Increase Flow . 345 134 

Amount Secreted . 346 134 

Over-feeding . 347 135 

Contents of . 348 135 

Sick Children . 488 189 

Successful . 749 288 

Unsuccessful . 750 288 

NUTMEG PLASTER . 802 315 

o 

OATMEAL WATER 675 260 

OBEDIENCE IN CHILDREN. 725 279 

OCCUPATION, Mental . . 45 29 

OPERATION, Cost of . 245 101 

OPIUM POISONING . 881 347 

ORANGEADE . 701 268 

ORANGE GELATIN .. 718 272 

OXYGEN . 163 72 

P 

PAINFUL MENSTRUATION . 980 412 

PAINLESS CHILDBIRTH . 230 96 

Accidents (Dr. Davis). 239 100 

Arguments in Favor of. 244 101 

Cash, Necessity of _ 246 102 

Cost of . 243 101 

Drugs not Safe . 242 101 

Dr. Davis’ Quotation .. 236 98 

Education .. 238 99 

Husband’s Endurance . 237 99 

Living and Dress . 233 97 

Meaning of . 230 96 

Methods Used . ... 241 101 

Operation, Cost of . 245 101 

Physician’s Duty . 232 97 

Reasons of . 234 98 

Specialist, Necessity of . 240 100 

Suffering. During . 231 97 

PASTEURIZATION . 401 156 

PAREGORIC . 1047 446 

PATENT FOODS . 396 153 

PEPTONIZED MILK . 674 260 

PEPTENZYME . 1055 449 

PERINEUM, Care of . 172 74 

In After-care „„ r . 186 79 

PHENACETINE . 1045 445 

PHOSPHORUS . 1024 437 

PINWORMS . 865 343 

PIGEON-TOE . 919 364 

PITTING, In Smallpox . 577 220 

PLASTERS . 799 315 

Spice Plaster . 800 315 

Pepper Plaster . 801 315 

Nutmeg Plaster . 802 315 

Cayenne-Pepper Plaster . 803 315 

Mustard Plaster . 792 313 

PNEUMONIA . 578 221 

Parts Affected . 579 221 

Symptoms . 581 222 

Pulse . 582 222 

Nursing Treatment . 583 223 

Nourishment . 584 223 

Feeding, How to . 585 223 

Liquids . 586 224 

Room, Care of . 587 224 

Temperature . 588 225 

Reduction of . 589 225 

POISON AND ANTIDOTES . 871 345 

Corrosive Sublimate . 872 346 

Bichlordie of Mercury . 872 346 

Carbolic Acid . 873 346 

Lye and Caustics . 874 346 

Alcohol . 875 346 

Fly Paper . 876 346 

Paris Green . 876 346 


VI 




























































































































































INDEX 


1 * 

Paragraph 

Arsenic . 876 

Rat Poison . 876 

Fish, Oysters . 877 

Ptomaines . 877 

Silver Nitrate . 878 

Strychnine . 879 

Tobacco . 880 

Opium . 881 

■ Laudanum . 881 

Morphine . 881 

Mushrooms . 882 

Lead Poisoning . 883 

Acetic Acid . 884 

Hydrochloric Acid . 884 

Nitric Acid . 884 

Nitro-muriatic Acid . 884 

Sulphuric Acid . 884 

Iodine . 885 

POISON OAK AND IVY 886 

Treatment . 887 

POTASSIUM CHLORATE 1022 

POULTICES . 793 

Flaxseed . 794 

Slippery Elm . 794 

Bread and Milk ... 795 

Bran . 796 

Hop . 797 

Starch . 798 

POTATO SOUP . 688 

PREGNANCY— 

Abdomen, Pains in . 68 

Bathing During . 44 

Bath, Sitz . 76 

Blood Pressure . 36 

Bowels . 28 

Breast . 10 

Coitus, During . 43 

Conception .89 

Consideration of . 19 

Constipation . 29 

Date, Fixing . 85 

Days, Number of . 82 

Diagnosis . 20 

Diet During . 27 

Disposition, Change in . 8 

Disturbances of . 60 

Douches .■-. 75 

Drugs . 33 

Examination, Chemical . 21 

Exercise . 41 

Fainting . 70 

Figure, During . 54 

Gums, Sore . 67 

Heart-burn .:. 72 

Hegar’s Sign . 13 

Hygiene of . 23 

Dress . 24 

Shoes . 25 

Corsets . 26 

Impressions During . 46 

Insomnia During . 64 

Kidneys . 35 

Length of . 81 

Massage . 42 

Menstruation . 2 

Missed Labor . 88 

Months . 83 

Morning Sickness . 6 

When Occur . 61 

Treatment . 62 

Drugs Used . 63 

Nipples . 30 

Numbness . 65 

Occupation, Mental . 45 

Quickening, Meaning of . 84 


Paragraph Page 


Signs and Symptoms of . 11 

Signs, Positive . 22 20 

Skin Eruption . 73 38 

Swelling, Hands and Feet. 78 40 

Table, Calculating . 86 42 

Explanation of . 87 42 

Toothache . 66 36 

Urinating . 71 38 

Uterus, Change in .. 14 17 

Form . 15 18 

Size . 16 18 

Consistency .... 17 19 

Position of . 18 19 

Vagina, Discoloration of. 11 16 

Softening of . 12 16 

Varicose Veins . 79 40 

PREPARATION OF ROOM— 

Antisepsis .. 95 46 

Applicators . 122 56 

Articles Needed ... 118 55 

Asepsis, Meaning of . 93 45 

Caution . 114 54 

Dish for Ligatures . 113 53 

Emergency Case . 125 58 

Forward . 91 45 

Infection . 96 46 

Instruments . 124 57 

Newspapers . 123 56 

Nurse’s Grip . 127 59 

Physician’s Grip . 126 59 

Room, Delivery . 116 55 

Bed . 117 55 

Selection of . 150 68 

Septic . 92 45 

Solutions, Bichloride . 108 51 

Lysol . 109 52 

Ziratol . 110 52 

Water, Hot and Cold. Ill 52 

Alcohol .,. 112 53 

Sterile . 94 46 

Sterilize, How to . 97 47 

Routine of . 98 47 

First Duty . 99 48 

Precaution of . 100 48 

Gloves, Wet . 101 49 

Gloves, Dry . 102 49 

At Home . 103 49 

Dressings . 104 50 

Instruments . 105 50 

Basins Needed . 107 51 

Supplies . 119 56 

Sponges, Cotton . 120 56 

Gauze . 121 56 

PREPARATION OF PATIENT . 129 60 

Arrival . 130 60 

First Duty . 131 60 

During Labor . 132 61 

Immediate Use for . 133 61 

Examination by Nurse. 135 62 

Enema, Extra . 152 68 

Drape Patient, How to . 1009 431 

PREMATURE INFANTS— 

Bath for ... 461 177 

Blue Spells . 472 181 

Choking . 473 181 

Cord . 466 178 

Cry . 450 173 

Daily Care . 468 179 

Diet, Correct . 455 175 

Diseases of . 469 180 

Dress for . 454 174 

Eyes, Care of . 463 178 

Feeding, Method of .. 458 176 

Forced Feeding . 459 177 

Genitalia . 467 178 

Incubator . 452 174 

Lungs ...-. 474 181 


Page 

346 

346 

347 

347 

347 

347 

347 

347 

347 

347 

347 

347 

348 

348 

348 

348 

348 

348 

348 

349 

437 

313 

313 

314 

314 

314 

314 

314 

263 

37 

28 

39 

26 

24 

15 

28 

43 

19 

24 

42 

41 

19 

23 

15 

34 

39 

25 

20 

27 

37 

33 

37 

38 

17 

21 

22 

22 

22 

30 

36 

25 

40 

28 

12 

43 

41 

14 

35 

35 

35 

31 

36 

29 

41 


VII 






























































































































































INDEX 


I * 

Paragraph Pape 


Meaning of . 449 173 

Mother’s Milk, Must Have. 451 173 

Mouth . 464 178 

Nose and Ears . 465 178 

Nursing . 448 172 

Over-feeding . 460 177 

Room, Care of . 453 174 

Shock . 462 178 

Thrush . 471 180 

Weight . 456 175 

Weighing of . 457 176 

PRICKLY HEAT . 291 117 

PROLAPSE OF BOWELS . 984 416 

Nursing Treatment . 985 417 

PRUNES, Stewed . 693 265 

Juice . 719 272 

Gelatin . 720 273 

PUBERTY . 977 409 

PUDDINGS .: . 262 

Sago . 681 262 

Cornstarch . 682 262 

Custard . 683 262 

PULSE RATE, Normal Infant. 308 123 

In After-Care . 184 78 

Infants . 485 188 

Pneumonia . 582 222 

Bronchitis . 615 237 

Croup . 631 243 

Normal . 830 326 

PUNISHMENT FOR CHILDREN. 726 279 

Q 

QUICKENING, Meaning of . 84 41 

QUININE . 1044 445 

R 

RAT POISON . 876 346 

RASH, In Measles . 534 204 

In Smallpox . 567 217 

In Scarlet Fever . 520 200 

RECTAL FEEDING . 756 293 

Articles Required . 756 293 

How to Give . 757 294 

Size Tube to Use . 758 294 

Amount Given . 759 295 

Indications for . 759 295 

Nourishment . 760 296 

RELATIVES, Education of . 151 68 

REPAIR WORK . 175 75 

RESPIRATIONS . 309 123 

Number of . 831 327 

RHEUMATISM .,. 924 366 

Nursing Treatment . 925 367 

Drugs .:. 926 368 

Special Diet . 927 368 

RHEUMALGINE . 1020 436 

RHEUMATIC . 1026 438 

RIBS, Fracture of . 912 361 

RICE WATER . 702 268 

RICKETS . 651 249 

Symptoms of . 652 249 

Constipation in . 653 249 

Bones Affected . 654 250 

Resistance . 655 250 

Nursing Treatment . 656 250 

Diet . 657 251 

Bathing . 658 252 

RINGWORM . 854 339 

Treatment . 855 339 

ROOM FOR DELIVERY. 116 55 

Selection of . 150 68 

ROUND WORMS . 864 342 


s 

Paragraph Pape 

SACCHRATED SOLUTION . 997. 425 

SAGE TEA . 706 269 

SALINE LAXATIVE . 1062 451 

SALITHIA . 1063 452 

SANTONIN AND CALOMEL. 1064 454 

SAUCE, Cream . 714 271 

SCALP, Care of .. 290 117 

SCARLET FEVER .. 198 

Dangers of . 513 198 

Germs . 514 198 

Contagion . 515 198 

Time of Year . 516 199 

Ages Affected . 517 199 

Mortality . 518 199 

Comparison . 519 199 

Rash . 520 200 

Complications . 521 200 

Nursing . 522 200 

Fresh Air . 523 201 

Diet . 524 201 

Bed . 527 202 

Kidneys, Care of . 528 202 

SCHOOL'LIFE OF CHILDREN . 731 281 

SCRAPED Beef . 677 260 

SCURVY . 659 252 

Cause of . 660 253 

Symptoms of . 661 253 

Nursing Treatment . 663 254 

Diet in . 664 254 

Bath, Salt . 665 254 

SEXUAL LIFE . 1010 432 

SEX CONTROL . 1011 432 

SHOES, During Pregnancy . 25 22 

SICK CHILD . 476 185 

Bed-Sores, Cause of . 499 193 

Brain . 478 186 

Breathing . 484 187 

Cleanliness . 501 194 

Colon Flushing . 503 195 

Diet Kitchen . 512 197 

Disinfection .. 511 197 

Facial Expression . 481 187 

Feeding . 496 192 

Food, Quantity of . 504 195 

Dietetics . 505 195 

Preparation of . 506 196 

Stale . 507 196 

Gas . 483 187 

Graduate, Kind of . 494 192 

Grinding Teeth . 487 189 

Ice-bag . 502 194 

Mastication . 509 197 

Medicine, How to Give . 491 190 

Kind of . 492 191 

Mouth . 480 186 

Cleanliness of . 510 197 

Noise . 498 193 

Nourishment . 494 192 

Nursing . '188 189 

Position of Patient . 508 196 

Pulse, Infants . 485 188 

Skin, Color of . 479 186 

Stools . 490 190 

Sweating . 482 187 

Symptoms . 477 186 

Throat Examination . 493 191 

Tongue . 486 189 

Urine, Color of . 489 189 

Warm Clothing . 500 193 

Water . 497 193 

SICK ROOM . 971 403 

Bedding, Linen, Dishes . 972 403 

Food . 973 404 

Discharges . 973 404 

Duties of Nurse . 973 405 


VIII 




















































































































































L\DE X 


S 

Paragraph 

SIGNS AND SYMPTOMS OF PREG¬ 


NANCY . 

SILVER NITRATE . 878 

SKIN, Eruption . 73 

Itching '. 74 

Stretching . 69 

Douches . 75 

Bath, Sitz . 76 

Eczema . 77 

Infants . 255 

Sick Child . 479 

SLEEP, During Pregnancy. 222 

Necessity of . 223 

Infants . 311 

Where to . 312 

Regularity . 315 

Disturbed . 316 

Mouth Open . 317 

With Mother . 318 

Outdoors . 319 

Hours of Airing . 320 

SLIPPERY ELM POULTICE 794 

SMALLPOX . 566 

Rash . 567 

Mortality in . 568 

Resistance of . 569 

Transmittance of . 570 

Contagion . 571 

Symptoms of . 572 

Complications . 573 

Nursing Treatment . 574 

Diet . 575 

Water . 576 

Pitting . 577 

SNAKE BITES . 834 

SODIUM BROMIDE 1049 

SOLUTIONS . 986 

Bichloride . 108 

Lysol . 109 

Ziratol . 110 

Water, Hot and Cold . ... Ill 

Alcohol . 112 

SOMNOS . 1036 

SORE THROAT . 897 

SOUPS, Navy Bean . 685 

Veal and Vegetable . 686 

Potato . 688 

Vegetable . 689 

Green Pea . 692 

SPICE PLASTER . 431 

How to Make . 800 

SPLINTERS . 909 

SPLINTS . 914 

SPONGES, Cotton . 120 

Gauze . 121 

SQUASH . 717 

STARCH POULTICE . 798 

STAMMERING AND STUTTERING.. 969 

Treatment . 970 

STERILE, Meaning of . 94 

STERILIZE, How to . 97 

Routine of . 98 

First Duty . 99 

Precaution of . 100 

Gloves, Wet . 101 

Gloves, Dry . 102 

At Home . 103 

Dressings . 104 

Instruments . 105 

Basins Needed . 107 

Cow’s Milk . 402 

STOMACH, Amount Holds . 322 

Shape of . 323 

Capacity of . 324 

Disturbances of . 325 

Physiology of . 326 


Paragraph Page 


Time Emptied . 327 129 

Hunger Appears . 328 129 

Juices of . 329 129 

Gas in . 342 133 

STOOLS, Infant . 413 161 

Abnormal ..-... 414 161 

Color of 416 162 

Treatment for . 417 162 

Large and Hard . 420 163 

Green in Colic . 428 166 

White Curds . 429 166 

STROPHANTHUS 1032 440 

STRYCHNINE . 1033 440 

Antidote for . 879 347 

ST. VITUS’ DANCE 962 396 

Treatment . 963 397 

Diet .:. 964 398 

Fowler's Solution ... . 965 398 

SUCKING THUMB . 825 325 

Treatment . 826 325 

SUGAR AND FAT IN MILK . 369 140 

SUNBURN . 844 333 

SULPHURIC ACID . 884 348 

SULPHUR FUMIGATION. 97! 405 

SUGGESTIVE THERAPEUTICS 1007 428 

SUPPLIES FOR PREGNANCY . 119 56 

SWELLING OF HANDS AND FEET 78 40 

Varicose Veins . 79 40 

Bandages . 80 40 

SWEETS SPIRITS OF NITRE . 1046 446 

T 

TABLE OF MEASURES . 989 419 

Food First Year . 990 420 

Approximate Equivalent . 991 420 

Drops . 992 422 

Digestion . 993 422 

Cooking Vegetables . 994 424 

Food per pound weight. 995 424 

TABLE IN PREGNANCY . 86 42 

Explanation of . 87 42 

Of Weights, Infants . 300 120 

TAENICIDE . 1062 453 

TAPEWORM . 866 343 

TEETHING, Dentition . 765 300 

Symptoms of . 766 300 

Appearance of . 767 300 

Treatment . 768 300 

Care of . 769 301 

Preparations for Cleaning. 770 301 

Clean, When to . 770 302 

Examination of . 770 302 

Eruption of . 771 302 

Table of Appearance . 771 303 

Toothache . 772 303 

TEMPERATURE, In Labor . 148 67 

In After Care . 183 78 

Baby’s Bath . 306 122 

Of Baby . 310 123 

In Measles . 533 204 

In Bronchitis . 617 238 

In Tonsillitis . 624 240 

THERMOMETER 777 307 

How to Use . 778 307 

Kind to Use . 779 307 

Taking Temperature . 778 307 

By Rectum . 781 308 

Time to Take . 782 308 

Care of Instrument . 783 309 

Temperature Curve. 784 309 

THRUSH . 471 180 

THUMB SUCKING . 825 325 

TOAST WATER . 707 269 

TOBACCO POISONING . 880 347 

TOMATOES, Stewed . 716 271 

TONGUE, In Sick Child . 486 189 

TONGUE-TIE . 847 334 


Page 

li 

347 

38 

39 

37 

39 

39 

39 

108 

186 

93 

94 

123 

124 

125 

125 

125 

126 

126 

126 

314 

217 

217 

218 

218 

218 

218 

219 

219 

219 

220 

220 

220 

328 

447 

417 

51 

52 

52 

52 

53 

441 

352 

262 

263 

263 

264 

265 

167 

315 

359 

362 

56 

56 

272 

314 

401 

402 

46 

47 

47 

48 

48 

49 

49 

49 

50 

50 

51 

156 

127 

127 

127 

127 

128 


IX 


























































































































































INDEX 


T 



V 




Paragraph 

Page 


Paragraph 

Page 

TONSILLITIS 

622 

240 

VAGINA, Discoloration of. 

li 

16 

Symptoms . 

623 

240 

Softening of . 

12 

16 

Temperature . 

624 

240 

VAGINAL ANTISEPTIC POWDER 

1061 

450 

Nursing . 

625 

241 

VARICOSE VEINS . 

79 

40 

Medical Treatment .. 

626 

241 

VEAL AND VEGETABLE SOUP 

686 

263 

Tablets . 

1023 

437 

VEAL BROTH 

690 

261 

TOOTHACHE, In Pregnancy . 

66 

36 

VEGETABLE SOUP .. 

689 

264 

TOXEMIA 

37 

26 

VENTRAL HERNIA 

938 

375 

TRAINING OF INFANTS AND 



VISITORS 

226 

94 

CHILDREN— 



VOMITING .. 

907 

357 

When to Start __ 

721 

277 

Nursing Treatment . 

908 

358 

When to Give Toys. 

721 

277 




When to Have Playground 

721 

277 




Example . 

722 

277 

Y\ 



Home Training .. 

723 

278 

WARTS .. 

843 

332 

Right- from Wrong .. 

724 

278 

WATER. In Constipation . 

30 

24 

Obedience .. 

725 

279 

Hot and Cold . 

111 

52 

Punishment ... 

726 

279 

Use of 

332 

130 

Unselfishness . 

727 

279 

Sick Child ... 

497 

193 

Fear . 

728 

280 


576 

220 

Presenting to Visitors .. 

729 

280 

WEANING .... 

439 

169 

Talking Before Children _ 

730 

281 

When to . 

440 

170 

School Life .. .. 

731 

281 

Nine Months . 

441 

170 

Mental Work .... . 

732 

281 

Results . 

442 

170 

Eye Strain . . ... 

733 

282 

Forced .. 

443 

170 

Diet While at School. 

734 

282 

Sickness, Cause of .... 

444 

170 

TRIPLE ARSENIC WITH NUCLEIN 

. 1052 

448 

Food Used . 

445 

171 

TRIPLE BROMIDES 

1017 

435 

Formulas .. 

446 

171 

TURPENTINE STUPE 

820 

322 

Normal Time for .. 

447 

172 

TYPHOID FEVER 

600 

230 

WEIGHT. Infants . 

292 

117 

Cause of ... 

601 

230 

Average of ..... 

293 

118 

Incubation . .... 

602 

231 

Loss in .... 

294 

118 

Symptoms . 

603 

231 

Normal . 

296 

119 

Blood Examination . 

604 

231 

Gain Should he. 

297 

119 

Nursing Treatment .. 

605 

232 

Record of ... 

298 

119 

Diet ... 

606 

233 

Chart Used .. 

299 

120 

Bowels . 

607 

234 

Table of .. 

300 

120 

Baths . 

608 

234 

Scales Used . 

301 

120 

Disinfectant .. 

609 

235 

Premature Infants . 

456 

175 

Complications . 

610 

235 

Increase in .. 

748 

288 




WET NURSE . 

359 

137 

u 



Qualifications for .. 

360 

138 

UMBILICAL HERNIA . 

936 

374 

WETTING BED 

814 

320 

UNSELFISHNESS IN CHILDREN. 

727 

279 

Causes of . . 

815 

320 

UNSUCCESSFUL NURSING . 

750 

288 

Treatment ..... 

816 

321 

URINE 

207 

88 

Incontinence Tablet __ 

818 

321 

In Sick Child . 

489 

189 

WHEY . 

697 

267 

In Scarlet Fever . 

528 

202 

WHOOPING COUGH 


206 

Amount of .. . 

819 

322 

Svmptoms of 

541 

206 

Frequency . 

71 

38 

Development .... 

542 

206 

UTENSILS ... 

1005 

427 

Cough . 

543 

207 

UTERINE TONIC 

. 1060 

450 

Cause of ..... 

544 

207 

UTERINE SEDATIVE 

1059 

449 

Complications . 

545 

207 

l TER LIS. Change in . . 

14 

17 

Nursing Treatment .. 

546 

208 

Form . . 

15 

18 

Diet . . 

548 

203 

Size ... 

16 

18 

Nourishment . 

549 

208 

Consistency . 

17 

19 

Fresh Air . 

550 

209 

Position of __ 

18 

19 

Medical Aid .. 

551 

209 

Height of . . 

185 

79 

WINE, Value of .. 

214 

91 


x 







































































































































\ 


' 

























% 



















